Adriana Lucia Gutierrez, PH.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY8213 Issued in MA

Practice address

Brooke Army Medical Center
3551 Roger Brooke Drive
San Houston, TX 78234

Phone

(210) 439-9391

NPI assigned

Mar 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Maura McGrane, MD, PC

  • Specialist
  • Beverly, MA
  • NPI 1760481733
  NPD (past)
• N E Psychological Consultants, Inc.

  • Clinical Psychologist
  • Lowell, MA
  • NPI 1922279033

  Clinical Neuropsychologist

  NPD (past)
• The Beverly Center, P.C.

  • Clinical Child & Adolescent Psychologist
  • Beverly, MA
  • NPI 1275509663
  NPD (past)

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1154593598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MERRIMACK ST",
            "address_2": "STE. 502",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521729",
            "telephone_number": "978-452-7038",
            "fax_number": "978-452-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DRIVE",
            "city": "SAN HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-439-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "ADRIANA",
        "middle_name": "LUCIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MA",
            "license": "8213",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MA",
            "license": "PSY8213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.