Individual provider Active NPI

David James Gutman

  • Mental Health Counselor
  • Garden Grove, CA
National Provider Identifier
1770264517
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
125974 Issued in CA
Practice address
12966 Euclid St Ste 280
Garden Grove, CA 92840-9202
Phone
(714) 823-4770
Fax
(714) 823-4777
NPI assigned
Jul 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 125974 CA Primary

Addresses

Primary practice location

12966 Euclid St Ste 280
Garden Grove, CA 92840-9202

Mailing address

12966 Euclid St Ste 280
Garden Grove, CA 92840-9202
Phone (714) 823-4770

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

LicenseStateTypeSpecialty
125974CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1770264517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12966 EUCLID ST STE 280",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928409202",
            "telephone_number": "714-823-4770",
            "fax_number": "714-823-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12966 EUCLID ST STE 280",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928409202",
            "telephone_number": "714-823-4770",
            "fax_number": "714-823-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "125974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.