Juan Carlos Gutierrez Jr., SFIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

34101 Farenholt Ave BLDG 14
San Diego, CA 92134-7000

Phone

(219) 743-1730

NPI assigned

Jan 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1881390904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13127 14TH ST",
            "address_2": "BUILDING 13127",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92058",
            "telephone_number": "760-763-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34101 FARENHOLT AVE BLDG 14",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347000",
            "telephone_number": "219-743-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_suffix": "Jr.",
        "credential": "SFIDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Gutierrez
• Jennifer Gutierrez
• Jesse Neil Gutierrez
• Jordan Sheared Gutierrez, LCSW
• Jordyn Reanna Gutierrez
• Juliannah Gutierrez
• Jyllian Gutierrez
• Kassandra D Gutierrez, RN
• Kiara Gutierrez, RBT
• Klarissa Gutierrez

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.