Provider Demographics
NPI:1942576996
Name:GUDIEL, WENDY ARELY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ARELY
Last Name:GUDIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5628 E SLAUSON AVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-2922
Mailing Address - Country:US
Mailing Address - Phone:323-318-9960
Mailing Address - Fax:
Practice Address - Street 1:201 NE PARK PLAZA DR STE 145
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5873
Practice Address - Country:US
Practice Address - Phone:360-729-8383
Practice Address - Fax:360-729-3534
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1054881041C0700X
WALW612515811041C0700X
CA314361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical