Individual provider Active NPI

Rebecca Gutierrez

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1871010728
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
123880 Issued in CA
Practice address
515 Columbia Ave Ste 200
Los Angeles, CA 90017
Phone
(714) 680-9000
Fax
(714) 680-8233
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 90667 CA
Social Worker 104100000X 90667 CA
Clinical Social Worker 1041C0700X 123880 CA Primary

Addresses

Primary practice location

515 Columbia Ave Ste 200
Los Angeles, CA 90017

Mailing address

515 Columbia Ave Ste 200
Los Angeles, CA 90017-1209
Phone (714) 680-9000

Other practice location 1

801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846
Phone (714) 680-9000 ext. 9034

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
I20241107003344 CA Practitioner - Clinical Social Worker 5597299925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
90667CAMDMental Health Counselor
123880CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. Current Accepting new patients
Special Service for Groups, Inc. CurrentSince Aug 25, 2024 Accepting new patients

Locations

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

515 Columbia Ave
Ste 200
Los Angeles, CA 90017
Phone (213) 249-9388

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1871010728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 COLUMBIA AVE STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171209",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 COLUMBIA AVE STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 E Chapman Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928313846",
            "country_code": "US",
            "telephone_number": "714-680-9000 x9034",
            "fax_number": "714-680-8233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "90667",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "90667",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "123880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.