Active NPI
Paloma Kassandra Gutierrez
- Speech-Language Assistant
- Gilbert, AZ
National Provider Identifier
1164084414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA11857
- Practice address
- 4100 S Lindsay Rd Ste 113
Gilbert, AZ 85297-1507 - Phone
- (480) 219-3953
- NPI assigned
- Jul 7, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SLPA11857 | AZ | Primary |
Addresses
Primary practice location
4100 S Lindsay Rd Ste 113
Gilbert, AZ 85297-1507
Mailing address
3700 E Carob Dr
Gilbert, AZ 85298-0427
Phone (623) 326-6710
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA11857 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562457600000",
"number": "1164084414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 E CAROB DR",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852980427",
"telephone_number": "623-326-6710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 S LINDSAY RD STE 113",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852971507",
"telephone_number": "480-219-3953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "PALOMA",
"middle_name": "KASSANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-07",
"last_updated": "2019-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA11857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.