Individual provider Active NPI

Elizabeth Juarez Gurrola

  • Attendant Care Provider
  • Chula Vista, CA
National Provider Identifier
1972191302
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
1100 Industrial Blvd SPC C29
Chula Vista, CA 91911-2679
Phone
(619) 518-3212
NPI assigned
Dec 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Primary

Addresses

Primary practice location

1100 Industrial Blvd SPC C29
Chula Vista, CA 91911-2679

Mailing address

511 Dennery Rd Apt 157
San Diego, CA 92154-8571
Phone (619) 852-1405

Other identifiers 1

IdentifierTypeStateIssuer
D7564004OtherCADRIVER LICENSE

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

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1972191302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 DENNERY RD APT 157",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921548571",
            "telephone_number": "619-852-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 INDUSTRIAL BLVD SPC C29",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112679",
            "telephone_number": "619-518-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURROLA",
        "first_name": "ELIZABETH",
        "middle_name": "JUAREZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "D7564004",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.