Provider Demographics
NPI:1669830022
Name:GUTIERREZ, BOBBI COLETTE KYLE (LMFT)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:COLETTE KYLE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:BOBBI
Other - Middle Name:C
Other - Last Name:KYLE HAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:987 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-7640
Mailing Address - Country:US
Mailing Address - Phone:408-641-1022
Mailing Address - Fax:
Practice Address - Street 1:987 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-7640
Practice Address - Country:US
Practice Address - Phone:408-641-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
CA142561106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health