Jordan Sheared Gutierrez, LCSW is a medicare enrolled "Social Worker - Clinical" provider in San Diego, California. Her current practice location is
4065 3rd Ave, San Diego, California. You can reach out to her office (for appointments etc.) via phone at
(619) 515-2419.
Jordan Sheared Gutierrez is licensed to practice in California (license number LCSW92666) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699121749.
Healthcare Provider's Profile
| Full Name | Jordan Sheared Gutierrez |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 4065 3rd Ave, San Diego, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699121749
- Provider Enumeration Date: 05/08/2016
- Last Update Date: 02/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 4587087168
- Enrollment ID: I20200721002538
Medical Identifiers
Medical identifiers for Jordan Sheared Gutierrez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1699121749 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | ASW74739 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW92666 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jordan Sheared Gutierrez allows following entities to bill medicare on her behalf.
| Entity Name | Family Health Centers Of San Diego, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447281936
PECOS PAC ID: 3476446378
Enrollment ID: O20040204000923 |
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| Entity Name | Monica Perlman Md Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134309305
PECOS PAC ID: 8820035884
Enrollment ID: O20050411001333 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jordan Sheared Gutierrez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jordan Sheared Gutierrez, LCSW
4065 3rd Ave,
San Diego, CA 92103-2184
Ph: () - | Jordan Sheared Gutierrez, LCSW
4065 3rd Ave,
San Diego, CA 92103-2184
Ph: (619) 515-2419 |
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