Provider Demographics
NPI:1871936245
Name:GUTIERREZ, ALLISON E (ANP-C)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:E
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:E
Other - Last Name:NOLTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP-C
Mailing Address - Street 1:2100 E COLORADO BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-5860
Mailing Address - Country:US
Mailing Address - Phone:626-229-9865
Mailing Address - Fax:626-229-9867
Practice Address - Street 1:2100 E COLORADO BLVD STE 1
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107
Practice Address - Country:US
Practice Address - Phone:626-229-9865
Practice Address - Fax:626-229-9867
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP22296363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner