Individual provider Active NPI

Lindsay Dawn Gutierrez, FNP-C

  • Family Nurse Practitioner
  • Redondo Beach, CA
National Provider Identifier
1508330978
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95019212 Issued in CA
Practice address
609 N Pacific Coast Hwy Ste 130
Redondo Beach, CA 90277-2107
Phone
(424) 265-0550
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 674187 CA
Nurse Practitioner 363L00000X 95019212 CA
Family Nurse Practitioner 363LF0000X 95019212 CA Primary

Addresses

Primary practice location

609 N Pacific Coast Hwy Ste 130
Redondo Beach, CA 90277-2107

Mailing address

16149 Maricopa LN
Apple Valley, CA 92307-7802

Other practice location 1

390 N Pacific Coast Hwy Ste 1030
El Segundo, CA 90245-0015
Phone (310) 906-2287

Other names 1

  • Lindsay Dawn Tillett Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
674187CAMDRegistered Nurse
95019212CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1508330978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16149 MARICOPA LN",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923077802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 N PACIFIC COAST HWY STE 130",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772107",
            "telephone_number": "424-265-0550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 N Pacific Coast Hwy Ste 1030",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902450015",
            "country_code": "US",
            "telephone_number": "310-906-2287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "LINDSAY",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "674187",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95019212",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "TILLETT",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.