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JORDAN SHEARED GUTIERREZ LCSW
NPI 1699121749
Social Worker - Clinical in San Diego, CA

Active since May 08, 2016PECOS EnrolledAccepts Medicare Assignment
4065 3RD AVE, SAN DIEGO, CA 92103(619) 515-2419 Get Directions Write a Review

NPPES record last updated: February 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 17, 2021, May 31, 2020, Nov 29, 2017 and 1 more (4 updates tracked since 2016).

About Jordan Sheared Gutierrez Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN SHEARED GUTIERREZ LCSW (NPI 1699121749) is an individual clinical provider in San Diego, California, licensed in California (LCSW92666) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1699121749
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJORDAN SHEARED GUTIERREZCredential: LCSW
Location Address4065 3RD AVESan Diego, CA 92103-2184
Mailing Address4065 3rd AveSan Diego, CA 92103-2184
Phone(619) 515-2419
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMay 8, 2016
Last NPPES UpdateFebruary 17, 20214 updates tracked since enumeration
NPPES CertifiedFebruary 17, 2021
✔ NPI 1699121749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · LCSW92666
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License ASW74739 (CA)
4065 3RD AVE, San Diego, CA 92103
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jordan Sheared Gutierrez Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587087168
PECOS Enrollment IDI20200721002538
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $62.10 – $184.71
Typical copayment $0.00 (range $15.52 – $46.17)
Most-billed visit code NA
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSEPH BRAUFMAN STEIN M.D.
Internal Medicine
4065 3RD AVE, SUITE 101
SAN DIEGO, CA 92103
San Diego County (619) 296-3800
JOHN WALTER MARSHALL SUDCC
Counselor (Addiction (Substance Use Disorder))
4065 3RD AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545
JOE ANTHONY SEPULVEDA M.D.
Psychiatry & Neurology (Psychiatry)
4065 3RD AVE
SAN DIEGO, CA 92103
San Diego County (619) 255-5120
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
4065 3RD AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545
ANTHONY P. POTENTE, MS, DDS, APC
Dentist (Endodontics)
4065 3RD AVE, SUITE 300
SAN DIEGO, CA 92103
San Diego County (619) 298-2291

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Gutierrez's NPI number?

The NPI number for Jordan Gutierrez is 1699121749. It was assigned to this individual provider in the NPPES registry on May 8, 2016.

Where is Jordan Gutierrez located?

Jordan Gutierrez practices at 4065 3rd Ave, San Diego, CA 92103. The listed phone number is (619) 515-2419.

What is Jordan Gutierrez's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jordan Gutierrez enrolled in Medicare?

Yes. Jordan Gutierrez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jordan Gutierrez was last updated on February 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.