Individual provider Active NPI

Rebecca Gutierrez, PSYD

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1417294729
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35981 Issued in CA
Practice address
2116 Arlington Ave Ste 100
Los Angeles, CA 90018-1300
Phone
(323) 605-4892
NPI assigned
Jan 7, 2013
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35981 CA Primary

Addresses

Primary practice location

2116 Arlington Ave Ste 100
Los Angeles, CA 90018-1300

Mailing address

PO Box 90961
Pasadena, CA 91109-0961
Phone (626) 702-9066

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251113002335 CA Practitioner - Clinical Psychologist 7719478114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Executive Mental Health, IncGroup PAC ID 0345209102, 47 clinicians

Practice addresses (Care Compare)

11835 W Olympic Blvd
Suite 1270E
Los Angeles, CA 90064-5053
Phone (310) 273-4843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Mental Health, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Brian Wu MD PHD Inc CurrentSince Nov 1, 2025 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1417294729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90961",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911090961",
            "telephone_number": "626-702-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 ARLINGTON AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900181300",
            "telephone_number": "323-605-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "35981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.