Active NPI
Jessica Lynn Gutierrez
- Day Training/Habilitation Specialist
- Lodi, CA
National Provider Identifier
1245975242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Day Training/Habilitation Specialist
- Practice address
- 1111 W Tokay St
Lodi, CA 95240-3965 - Phone
- (209) 336-8206
- NPI assigned
- May 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Community Health Worker | 172V00000X | |||
| Day Training/Habilitation Specialist | 373H00000X | Primary |
Addresses
Primary practice location
1111 W Tokay St
Lodi, CA 95240-3965
Mailing address
1111 W Tokay St
Lodi, CA 95240-3965
Phone (209) 695-8255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F7292285 | Other | CA | DRIVER LICENSE |
Other names 1
- Jessica Lynn Owens
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jowens@glom-arf.org | Direct |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glom Substance Abuse Program | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Stockton, CA
- NPI 1629755970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746576000000",
"number": "1245975242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 W TOKAY ST",
"city": "LODI",
"state": "CA",
"postal_code": "952403965",
"telephone_number": "209-695-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 W TOKAY ST",
"city": "LODI",
"state": "CA",
"postal_code": "952403965",
"telephone_number": "209-336-8206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "JESSICA",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-03",
"last_updated": "2025-05-07",
"certification_date": "2025-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "F7292285",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jowens@glom-arf.org",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Merced",
"address_1": "1020 W Main St",
"city": "Merced",
"state": "CA",
"country_code": "US",
"postal_code": "953404521",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "OWENS",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.