Active NPI
Cynthia Edick Gutierrez, RD
- Registered Dietitian
- Fontana, CA
National Provider Identifier
1801919675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 930210
- Practice address
- 99621 Sierra Ave
Fontana, CA 92335 - Phone
- (909) 427-6109
- NPI assigned
- Apr 9, 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 930210 | CA | Primary |
Addresses
Primary practice location
99621 Sierra Ave
Fontana, CA 92335
Mailing address
11711 Collett Ave Apt 2622
Riverside, CA 92505-3791
Phone (661) 755-5934
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 |
|---|---|---|---|
| 930210 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1801919675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11711 COLLETT AVE APT 2622",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925053791",
"telephone_number": "661-755-5934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99621 SIERRA AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "92335",
"telephone_number": "909-427-6109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "CYNTHIA",
"middle_name": "EDICK",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "930210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.