1669294120 NPI number — NAYELI VICTORIA GUTIERREZ SAAVEDRA

Table of content: NAYELI VICTORIA GUTIERREZ SAAVEDRA (NPI 1669294120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669294120 NPI number — NAYELI VICTORIA GUTIERREZ SAAVEDRA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUTIERREZ SAAVEDRA
Provider First Name:
NAYELI
Provider Middle Name:
VICTORIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669294120
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5312 CASTLE STREET
Provider Second Line Business Mailing Address:
APT A
Provider Business Mailing Address City Name:
FAIR OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-216-5335
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3101 SUNSET BLVD
Provider Second Line Business Practice Location Address:
STE 1A
Provider Business Practice Location Address City Name:
ROCKLIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-773-0211
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)