Active NPI
Diane E Gutierrez, LISW
- Clinical Social Worker
- Santa Fe, NM
National Provider Identifier
1669566360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-3735
- Practice address
- 1700 Cerrillos Road
Santa Fe, NM 87505 - Phone
- (505) 946-9263
- Fax
- (505) 983-6243
- NPI assigned
- Oct 3, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-3735 | NM | Primary |
Addresses
Primary practice location
1700 Cerrillos Road
Santa Fe, NM 87505
Mailing address
02 Sunset View
Santa Fe, NM 87506
Phone (505) 690-2190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N1949 | Medicaid | NM |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-3735 | NM | MD | Clinical Social Worker |
| 3735 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santo Domingo Health Clinic | Past | Accepting new patients | |
| Cochiti Health Clinic | Past | Accepting new patients | |
| San Felipe Health Clinic | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Cochiti Pueblo, NM
- NPI 1093814691
-
- General Acute Care Hospital
- San Felipe, NM
- NPI 1831274851
-
- General Acute Care Hospital
- Santo Domingo Pueblo, NM
- NPI 1376632695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669566360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "02 SUNSET VIEW",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87506",
"telephone_number": "505-690-2190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 CERRILLOS ROAD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87505",
"telephone_number": "505-946-9263",
"fax_number": "505-983-6243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "DIANE",
"middle_name": "E",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-3735",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N1949",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.