Active NPI
Fernando Jose Gutierrez, ED.D.
- Counseling Psychologist
- Pasadena, CA
National Provider Identifier
1275854879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY8801
- Practice address
- 2810 E del Mar Blvd
11A
Pasadena, CA 91107-4321 - Phone
- (818) 457-0376
- Fax
- (818) 824-3442
- NPI assigned
- Jun 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY8801 | CA | Primary |
Addresses
Primary practice location
2810 E del Mar Blvd
11A
Pasadena, CA 91107-4321
Mailing address
PO Box 70160
Pasadena, CA 91117-7160
Phone (818) 457-0376
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8801 | CA | MD | Counseling Psychologist |
| 8801 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288569600000",
"number": "1275854879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70160",
"city": "PASADENA",
"state": "CA",
"postal_code": "911177160",
"telephone_number": "818-457-0376",
"fax_number": "818-824-3442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 E DEL MAR BLVD",
"address_2": "11A",
"city": "PASADENA",
"state": "CA",
"postal_code": "911074321",
"telephone_number": "818-457-0376",
"fax_number": "818-824-3442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "FERNANDO",
"middle_name": "JOSE",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-17",
"last_updated": "2010-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY8801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.