Active NPI
Jacob James Gutierrez, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1902391717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A163989
- Practice address
- 631A Maple Ave
Los Angeles, CA 90014-2211 - Phone
- (213) 673-3049
- NPI assigned
- Jun 25, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A163989 | CA | Primary |
Addresses
Primary practice location
631A Maple Ave
Los Angeles, CA 90014-2211
Mailing address
PO Box 920
Artesia, CA 90702-0920
Phone (213) 673-3084
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A163989 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711497600000",
"number": "1902391717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 920",
"city": "ARTESIA",
"state": "CA",
"postal_code": "907020920",
"telephone_number": "213-673-3084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631A MAPLE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900142211",
"telephone_number": "213-673-3049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "JACOB",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-25",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A163989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.