DR. JACQUELINE GUTIERREZ (NPI# 1427437151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427437151 |
Entity Type | Individual |
Full Name | DR. JACQUELINE GUTIERREZ |
Credential | MD |
Practice Address |
221 3rd St W Bldg 1040 Jbsa Randolph TX 78150-4800 |
Practice Telephone | 2106524267 |
Mailing Telephone | 2106524267 |
Enumeration Date | 2015-05-27 |
Last Update Date | 2020-09-23 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
Y | 171000000X | Military Health Care Provider | Other Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
301 Fisher St, Rm 1f325, Keesler Afb, MS 395342508 | 2283763728 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588142905 | Jacqueline Gutierrez | Specialist/Technologist | 2516 N 93rd Ct Apt 13, Omaha, NE 68134-5834 | 2018-07-30 |
1073090031 | Jacqueline Gutierrez | Student in an Organized Health Care Education/Training Program | 333 S Beaudry Ave, Los Angeles, CA 90017-1466 | 2018-07-23 |
1841783347 | Jacqueline Gutierrez | Counselor | 2620 Industry Way, Lynwood, CA 90262 | 2018-06-08 |
1093247025 | Jacqueline Rose Gutierrez | Counselor | 11731 Telegraph Rd, Santa Fe Springs, CA 90670-3675 | 2017-03-29 |
1861851982 | Jacqueline Gutierrez | Case Manager/Care Coordinator | 5300 Angeles Vista Blvd, View Park, CA 90043-1648 | 2016-02-17 |
1982930764 | Jacqueline Gutierrez | Counselor | 8928 Volunteer Ln Ste 100, Sacramento, CA 95826-3238 | 2009-10-28 |
Street Address |
221 3RD ST W BLDG 1040 |
City | JBSA RANDOLPH |
State | TX |
Zip Code | 78150-4800 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427042183 | Karen Ann Ryan-philpott | Pediatrics | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2005-09-08 |
1235695412 | Alexandra Schulte | General Practice | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2019-02-13 |
1225525926 | Kristyn Brooke Loggins | Pharmacist | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2018-04-18 |
1053831149 | Angelique Stacey Ann Forrester | Family Medicine | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2017-06-21 |
1770014383 | Daniel Stephen Catts | Pediatrics | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2017-03-24 |
1386191252 | Kelly Cooper | Dentist | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2016-09-07 |
1972974061 | Jeffery Rueben | Physician Assistant | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-10-14 |
1053787259 | Leanne Putnam | Nurse Practitioner | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-08-11 |
1780066035 | Karla Renise Ivy | Family Medicine | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-06-23 |
1699153486 | Andrew Grove | Dentist | 221 3rd St W Bldg 1040, Jbsa Randolph, TX 78150-4800 | 2015-05-12 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
Find all providers in zip 78150 |
Taxonomy Code | 171000000X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
Notes: [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841805454 | Tri Huynh Minh Nguyen | Military Health Care Provider | 7826 Enchanted Cliff Dr, El Paso, TX 79911-7508 | 2020-09-10 |
1700355237 | William Christopher Petty | Military Health Care Provider | 21227 Torch Street, Biggs Field, TX 79918 | 2018-11-14 |
1346629094 | Grada Berry | Military Health Care Provider | 2520 Heather Brook Ln Apt 804, Arlington, TX 76006-5177 | 2015-05-28 |
1215323514 | Kathleen Schurr | Military Health Care Provider | 47th Medical Group, Laughlin Afb, TX 78840 | 2015-04-13 |
1639518616 | Treble Clef Technologies | Military Health Care Provider | 3233 Tomahawk St, El Paso, TX 79936-2315 | 2013-06-23 |
1679837355 | Jeffrey Hoffmann | Military Health Care Provider | 1640 N Zaragoza Rd, Apt 118, El Paso, TX 79936-8004 | 2012-06-27 |
1194022566 | William Resto-rivera | Military Health Care Provider | J Street Bldg 3000, Federal Medical Center Carswell, Fort Worth, TX 76127-0066 | 2011-02-22 |
1437456373 | Jennifer Leigh Noblin | Military Health Care Provider | Sheppard Afb Mental Health Clinic, 149 Hart St. Bldg 1200, Wichita Falls, TX 76311 | 2011-02-11 |
1609179159 | Verisha Virginia Dixon | Military Health Care Provider | 81945 Fm 2252 Ste 115, Cheroke Medical Services, Garden Ridge, TX 78266 | 2010-12-06 |
1215190004 | Joni Patricia Gumban | Military Health Care Provider | 409 Greene St, Webster, TX 77598-6701 | 2008-07-02 |
Find all providers with the same taxonomy |
City | JBSA RANDOLPH |
Zip Code | 78150 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.