Provider Demographics
NPI:1619702347
Name:GUTIERREZ OJEDA, ALMA GLORIA
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:GLORIA
Last Name:GUTIERREZ OJEDA
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 1:4850 BANNING AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-2871
Mailing Address - Country:US
Mailing Address - Phone:651-442-2854
Mailing Address - Fax:
Practice Address - Street 1:1400 VAN BUREN ST NE STE 200
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-3017
Practice Address - Country:US
Practice Address - Phone:612-778-3748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator