Leticia Gutierrez-Lopez, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17604 Issued in CA

Practice address

11731 Telegraph Rd
Building G
Santa Fe Springs, CA 90670-3675

Phone

(626) 255-3955

Fax

(562) 942-9789

NPI assigned

Feb 5, 2007

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Wellness PartnersGroup PAC ID 0749531259, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mental Wellness Partners

  • Psychiatry Physician
  • Upland, CA
  • NPI 1972096295
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194864256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD",
            "address_2": "BUILDING G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703675",
            "telephone_number": "626-255-3955",
            "fax_number": "562-942-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD",
            "address_2": "BUILDING G",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703675",
            "telephone_number": "626-255-3955",
            "fax_number": "562-942-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ-LOPEZ",
        "first_name": "LETICIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julio Cesar Guevara
• Lisa Guillen-Powers
• Rafael Guirado
• Candice Guizar
• Jennifer Gutierrez Fernandez, AMFT
• Ana B. Gutierrez
• Brenda Gutierrez
• Calvin Gutierrez
• David Gutierrez
• Jacqueline Rose Gutierrez, MS, LMFT 122964

• Clinical Psychologist in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.