Active NPI
Marcella C Gutierrez, FNP, NP-C
- Family Nurse Practitioner
- Highland, CA
National Provider Identifier
1053570408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 17545
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 64424 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
| 17545 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Specialist
- Palm Springs, CA
- NPI 1982879383
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.