Jacqueline Rose Gutierrez, MS, LMFT 122964

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT122964 Issued in CA

Practice address

11731 Telegraph Rd Ste K
Santa Fe Springs, CA 90670-6815

Phone

(626) 802-8247

Fax

(626) 967-6027

NPI assigned

Mar 29, 2017

Last updated

Mar 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Campbell, CA
  • NPI 1255496105
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1336458934
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Santa Fe Springs, CA
  • NPI 1588322044
  NPD

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1093247025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD STE K",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706815",
            "telephone_number": "626-802-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD STE K",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706815",
            "telephone_number": "626-802-8247",
            "fax_number": "626-967-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "MS, LMFT 122964",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT122964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jagutierrez@pacificclinics.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Professional Email",
            "address_1": "1126 N Grand Ave Ste D",
            "city": "Covina",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917241552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leticia Gutierrez-Lopez, PSY.D.
• Ana B. Gutierrez
• Brenda Gutierrez
• Calvin Gutierrez
• David Gutierrez
• Juan Jose Gutierrez
• Lauriane Clarisse Gutierrez
• Lorena Gutierrez, LCSW
• Susan Gutierrez
• Jorge Gutirrez

• Marriage & Family Therapist in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.