Individual provider Active NPI

Dhanna Jessica Saco Gutierrez

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1205618584
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
299078 Issued in AZ
Practice address
4451 E Oak St
Phoenix, AZ 85008-2410
Phone
(602) 957-2220
NPI assigned
Oct 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 299078 AZ Primary

Addresses

Primary practice location

4451 E Oak St
Phoenix, AZ 85008-2410

Mailing address

3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219001290 AZ Practitioner - Nurse Practitioner 0941650873 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
299078AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifewell Behavioral Wellness CurrentSince Dec 6, 2023 Accepting new patients
Terros, Inc. Current Accepting new patients
Terros, Inc. CurrentSince Jan 11, 2025 Accepting new patients
Terros Inc CurrentSince Jan 11, 2025 Accepting new patients
Lifewell Behavioral Wellness PastSince Jun 22, 2021 Accepting new patients

Locations

262 E University Dr
Mesa, AZ 85201
Phone 60280828005539

6915 E Main St
Ste 200
Mesa, AZ 85207

3540 E Baseline Rd
Phoenix, AZ 85042
Phone (623) 267-5200

3003 N Central Ave
Ste 400
Phoenix, AZ 85012
Phone (602) 351-3015

4451 E Oak St
Phoenix, AZ 85008
Phone (602) 957-2220

4909 E McDowell Rd
Phoenix, AZ 85008
Phone (602) 244-9591

10844 N 23rd Ave
Ste 100
Phoenix, AZ 85029
Phone (602) 208-2800

40 E Mitchell Dr
Ste 100
Phoenix, AZ 85012
Phone (602) 995-7474

202 E Earll Dr
Ste 200
Phoenix, AZ 85012
Phone (602) 599-5404

10844 N 23rd Ave
Ste 200
Phoenix, AZ 85029
Phone (602) 353-2340

Interoperability endpoints

  • Direct secure messaging: dhanna.gutierrezrn.p1@direct.lifewell.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1205618584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 E OAK ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850082410",
            "telephone_number": "602-957-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "DHANNA JESSICA",
        "middle_name": "SACO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "299078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.