Individual provider Active NPI

Holly Renee Gutstein

  • Marriage & Family Therapist
  • Lemon Grove, CA
National Provider Identifier
1497062368
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
78986 Issued in CA
Practice address
3434 Grove St
Lemon Grove, CA 91945-1812
Phone
(619) 592-1987
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 78986 CA Primary

Addresses

Primary practice location

3434 Grove St
Lemon Grove, CA 91945-1812

Mailing address

3434 Grove St
Lemon Grove, CA 91945-1812
Phone (619) 592-1987

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
I20250711001150 CA Practitioner - Marriage and Family Therapist 7315452299 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
78986CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 26, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 26, 2025 Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1497062368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 GROVE ST",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451812",
            "telephone_number": "619-592-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 GROVE ST",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451812",
            "telephone_number": "619-592-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTSTEIN",
        "first_name": "HOLLY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "78986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemon Grove, CA

Sources for this page

Verify at the official NPI Registry.