Active NPI
Angela Patricia Gutierrez, PHD
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1346817244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32652
- Practice address
- 3350 La Jolla Village Dr
San Diego, CA 92161-0002 - Phone
- (858) 552-8585
- NPI assigned
- Jun 9, 2021
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 32652 | CA | Primary |
Addresses
Primary practice location
3350 La Jolla Village Dr
San Diego, CA 92161-0002
Mailing address
10730 Esmeraldas Dr
San Diego, CA 92124-2010
Phone (816) 739-5710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11750 W 135TH St
Suite 1544
Overland Park, KS 66221-9395
6203 San Ignacio Ave
Suite 110
San Jose, CA 95119-1371
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32652 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1346817244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10730 ESMERALDAS DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921242010",
"telephone_number": "816-739-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 LA JOLLA VILLAGE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921610002",
"telephone_number": "858-552-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "ANGELA",
"middle_name": "PATRICIA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-09",
"last_updated": "2021-06-09",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.