Active NPI
Andres Gutierrez
- Behavior Analyst
- Mission Viejo, CA
National Provider Identifier
1649787003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-45092
- Practice address
- 24702 Pallas Way
Mission Viejo, CA 92691-4663 - Phone
- (949) 303-8599
- NPI assigned
- Jan 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-33563 | CA | |
| Behavior Analyst | 103K00000X | 1-20-45092 | CA | Primary |
Addresses
Primary practice location
24702 Pallas Way
Mission Viejo, CA 92691-4663
Mailing address
24702 Pallas Way
Mission Viejo, CA 92691-4663
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-33563 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1649787003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24702 PALLAS WAY",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926914663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24702 PALLAS WAY",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926914663",
"telephone_number": "949-303-8599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "ANDRES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-08",
"last_updated": "2020-10-14",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-17-33563",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-20-45092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.