Active NPI
Dea Lynn Gutierrez, SUDRC
- Addiction (Substance Use Disorder) Counselor
- San Diego, CA
National Provider Identifier
1457038952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 14906
- Practice address
- 1733 Euclid Ave
San Diego, CA 92105-5414 - Phone
- (619) 263-0433
- Fax
- (619) 263-3992
- NPI assigned
- Jun 28, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 14906 | CA | Primary |
Addresses
Primary practice location
1733 Euclid Ave
San Diego, CA 92105-5414
Mailing address
1890 Washington St
Lemon Grove, CA 91945-4264
Phone (619) 603-3651
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14906 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1457038952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1890 WASHINGTON ST",
"city": "LEMON GROVE",
"state": "CA",
"postal_code": "919454264",
"telephone_number": "619-603-3651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1733 EUCLID AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921055414",
"telephone_number": "619-263-0433",
"fax_number": "619-263-3992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "DEA",
"middle_name": "LYNN",
"credential": "SUDRC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "14906",
"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 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.