Jennifer L Gutierrez, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT41011 Issued in CA

Practice address

68 Willow Rd
Menlo Park, CA 94025-3653

Phone

(877) 390-6659

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Jennifer L Johnston Former name

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Reborn Pelvic Health and WellnessGroup PAC ID 0941738272, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Ihc Health Services Inc

  • Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033822085

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Reborn Pelvic Health & Wellness

  • Physical Therapy Clinic/Center
  • Murray, UT
  • NPI 1740884907

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Performance Rehab Clinic-Salt Lake

  • Physical Therapy Clinic/Center
  • Cottonwood Heights, UT
  • NPI 1114055837
  Medicare reassignment NPD
• Utah Luna Care Physical Therapy LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1437802246
  Medicare reassignment NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• North Carolina Luna Care Physical Therapy LLC

  • Physical Therapist
  • Hendersonville, NC
  • NPI 1124626148
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1740388297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E CHARLESTON RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943064247",
            "telephone_number": "650-618-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 WILLOW RD",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253653",
            "telephone_number": "877-390-6659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E Charleston Rd",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943064247",
            "country_code": "US",
            "telephone_number": "650-618-3360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007873",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT41011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8936908",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIE",
            "identifier": "159304",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "8972GU",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650024224",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A010",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JOHNSTON",
            "middle_name": "L",
            "credential": "MSPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Guide Behavioral Health LLC
• Susan Elaine Guild, LCSW
• Alyse Michele Gulack, AUD
• Marc Joseph Gurwith, M.D.
• Frida Dolores Gutierrez
• Stephanie Alejandra Guzman Lopez, MSW, LCSW, PPSC
• Constance L Habash, MA, LMFT
• Jon Randolph Haber, PHD
• Grant F. Halischuk, MD
• Leslie A Hall, PH.D.

• Physical Therapist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.