Individual provider Active NPI

Joselyn Serrano Gutierrez

  • Behavior Analyst
  • San Pablo, CA
National Provider Identifier
1073163705
Registry record updated Sep 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2955 17TH St
San Pablo, CA 94806-2338
Phone
(415) 810-9265
NPI assigned
Sep 15, 2019
Last updated
Sep 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

2955 17TH St
San Pablo, CA 94806-2338

Mailing address

2970 Hilltop Mall Rd Ste 104
Richmond, CA 94806-1948

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568505600000",
    "number": "1073163705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 HILLTOP MALL RD STE 104",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948061948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 17TH ST",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948062338",
            "telephone_number": "415-810-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO GUTIERREZ",
        "first_name": "JOSELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-15",
        "last_updated": "2019-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2019; 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.