Individual provider Active NPI

Rick Gutierrez, COTA/L

  • Occupational Therapy Assistant
  • Los Alamitos, CA
National Provider Identifier
1629588611
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA94 Issued in CA
Practice address
4772 Katella Ave Ste 100
Los Alamitos, CA 90720-2681
Phone
(562) 430-8700
NPI assigned
Oct 4, 2017
Last updated
Oct 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA94 CA Primary

Addresses

Primary practice location

4772 Katella Ave Ste 100
Los Alamitos, CA 90720-2681

Mailing address

1700 Adams Ave Ste 103
Costa Mesa, CA 92626-4865
Phone (714) 556-2288

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
OTA94CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shattuck Rehabilitation Services PastSince Feb 2, 2004 Accepting new patients
Hands on Hands Rehabilitation Center, Inc PastSince Jun 1, 2017 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rick.gutierrez.p29@direct.newportmed.nextgenshare.com

Organizations & group practices 2

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1629588611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ADAMS AVE STE 103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264865",
            "telephone_number": "714-556-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 KATELLA AVE STE 100",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202681",
            "telephone_number": "562-430-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "RICK",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA94",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.