Individual provider Active NPI

Marcella C Gutierrez, FNP, NP-C

  • Family Nurse Practitioner
  • Highland, CA
National Provider Identifier
1053570408
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17545 Issued in CA
Practice address
7000 Boulder Ave
Highland, CA 92346-3348
Phone
(909) 862-1191
Fax
(909) 862-2768
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17545 CA Primary
Critical Care Medicine Registered Nurse 163WC0200X 64424 CA

Addresses

Primary practice location

7000 Boulder Ave
Highland, CA 92346-3348

Mailing address

PO Box 12209
San Bernardino, CA 92423-2209
Phone (909) 862-1191

Other names 1

  • Mrs. Marcella C Gutierrez-Becerra Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
64424CAMDOral and Maxillofacial Surgery (Dentist)
17545CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jorge G. Gutierrez, M.D. a Medical Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1053570408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12209",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924232209",
            "telephone_number": "909-862-1191",
            "fax_number": "909-862-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 BOULDER AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463348",
            "telephone_number": "909-862-1191",
            "fax_number": "909-862-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MARCELLA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "FNP, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "17545",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "64424",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCELLA",
            "last_name": "GUTIERREZ-BECERRA",
            "middle_name": "C",
            "prefix": "MRS.",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Highland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.