Individual provider Active NPI

Melissa Jean Gutierrez

  • Marriage & Family Therapist
  • Mission Viejo, CA
National Provider Identifier
1700310174
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
98075 Issued in CA
Practice address
27261 Las Ramblas Ste 220
Mission Viejo, CA 92691-6468
Phone
(909) 303-2505
NPI assigned
Apr 12, 2017
Last updated
Oct 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 98075 CA Primary

Addresses

Primary practice location

27261 Las Ramblas Ste 220
Mission Viejo, CA 92691-6468

Mailing address

27261 Las Ramblas Ste 220
Mission Viejo, CA 92691-6468
Phone (909) 303-2505

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
I20241206000651 CA Practitioner - Marriage and Family Therapist 0143756791 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
98075CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Pathways Family Counseling Inc Marriage & Family Therapist CurrentSince Nov 1, 2024 Accepting new patients
Personalized Treatment & Intervention Services CurrentSince Nov 1, 2024 Accepting new patients

Locations

11800 Central Ave
Ste 225
Chino, CA 91710
Phone (909) 576-3889

201 Spear St
Ste 1100
San Francisco, CA 94105
Phone (415) 651-4333

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1700310174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27261 LAS RAMBLAS STE 220",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916468",
            "telephone_number": "909-303-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27261 LAS RAMBLAS STE 220",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916468",
            "telephone_number": "909-303-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MELISSA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.