Active NPI
Ronald J Gutierrez, PTA
- Physical Therapy Assistant
- San Jose, CA
National Provider Identifier
1477560746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1324
- Practice address
- 7164 Josslyn Dr
San Jose, CA 95120-3320 - Phone
- (408) 988-6868
- Fax
- (408) 492-9825
- NPI assigned
- Aug 1, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1324 | CA | Primary |
Addresses
Primary practice location
7164 Josslyn Dr
San Jose, CA 95120-3320
Mailing address
7164 Josslyn Dr
San Jose, CA 95120-3320
Phone (408) 988-6868
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 |
|---|---|---|---|
| 1324 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477560746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7164 JOSSLYN DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951203320",
"telephone_number": "408-988-6868",
"fax_number": "408-492-9825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7164 JOSSLYN DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951203320",
"telephone_number": "408-988-6868",
"fax_number": "408-492-9825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "RONALD",
"middle_name": "J",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "1324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.