Individual provider Active NPI

Edith Mayte Gutierrez

  • Social Worker
  • Bakersfield, CA
National Provider Identifier
1578619839
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW76827 Issued in CA
Practice address
718 Workman St
Bakersfield, CA 93307
Phone
(559) 558-4051
NPI assigned
Jan 26, 2007
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW76827 CA
Social Worker 104100000X LCSW76827 CA Primary
Clinical Social Worker 1041C0700X ASW71961 CA

Addresses

Primary practice location

718 Workman St
Bakersfield, CA 93307

Mailing address

3433 W Shaw Ave Ste 108
Fresno, CA 93711-3229
Phone (559) 558-4051

Other practice location 1

5121 Stockdale Hwy
Bakersfield, CA 93309-2656
Phone (661) 868-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20210408001312 CA Practitioner - Clinical Social Worker 3476960568 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW76827CAMDSocial Worker
ASW71961CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Family Health CurrentSince Feb 22, 2021 Accepting new patients
Omni Family Health Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2023 Accepting new patients
Omni Family Health CurrentSince Feb 22, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

3733 San Dimas St
Bakersfield, CA 93301
Phone (661) 631-3008

277 E Front St
Buttonwillow, CA 93206
Phone (661) 630-7381

2505 Merced St
Fresno, CA 93721
Phone (559) 369-4625

355 Campus Dr
Ste E
Hanford, CA 93230
Phone (559) 584-0668

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

925 G St
Reedley, CA 93654
Phone (559) 493-5307

655 S Central Valley Hwy
Shafter, CA 93263
Phone (661) 459-1927

659 S Central Valley Hwy
Shafter, CA 93263
Phone (661) 459-1913

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1578619839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W SHAW AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113229",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 WORKMAN ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93307",
            "telephone_number": "559-558-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5121 Stockdale Hwy",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933092656",
            "country_code": "US",
            "telephone_number": "661-868-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "EDITH",
        "middle_name": "MAYTE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW76827",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW76827",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW71961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3733 San Dimas St",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933011407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.