Individual provider Active NPI

Helen Domingo Gutierrez

  • Assisted Living Facility
  • Chandler, AZ
National Provider Identifier
1518152057
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
ALH6113 Issued in AZ
Practice address
1371 W Mulberry Dr
Chandler, AZ 85286-6958
Phone
(480) 857-8410
Fax
(480) 857-8410
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X ALH6113 AZ Primary

Addresses

Primary practice location

1371 W Mulberry Dr
Chandler, AZ 85286-6958

Mailing address

11642 E Regal CT
Chandler, AZ 85249-4545
Phone (480) 205-4018

Other identifiers 1

IdentifierTypeStateIssuer
ALH6113OtherAZSTATE

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

LicenseStateTypeSpecialty
ALH6113AZMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1518152057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11642 E REGAL CT",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852494545",
            "telephone_number": "480-205-4018",
            "fax_number": "480-857-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 W MULBERRY DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866958",
            "telephone_number": "480-857-8410",
            "fax_number": "480-857-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "HELEN",
        "middle_name": "DOMINGO",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALH6113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "ALH6113",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.