Active NPI
Jonathan Jose Gutierrez
- Assisted Living Facility
- Concord, CA
National Provider Identifier
1760131395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 079201110
- Practice address
- 1312 5TH Ave
Concord, CA 94518-1107 - Phone
- (925) 286-2221
- NPI assigned
- Mar 21, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 079201110 | CA | Primary |
Addresses
Primary practice location
1312 5TH Ave
Concord, CA 94518-1107
Mailing address
1312 5TH Ave
Concord, CA 94518-1107
Phone (925) 286-2221
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 |
|---|---|---|---|
| 079201110 | CA | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1760131395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312 5TH AVE",
"city": "CONCORD",
"state": "CA",
"postal_code": "945181107",
"telephone_number": "925-286-2221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312 5TH AVE",
"city": "CONCORD",
"state": "CA",
"postal_code": "945181107",
"telephone_number": "925-286-2221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "JONATHAN",
"middle_name": "JOSE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-21",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "CA",
"license": "079201110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.