Provider Demographics
NPI:1538041322
Name:GUTIERREZ, DIGIOVANNI ROSENDO (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:DIGIOVANNI
Middle Name:ROSENDO
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6656 E DWIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1197
Mailing Address - Country:US
Mailing Address - Phone:559-789-1613
Mailing Address - Fax:
Practice Address - Street 1:6656 E DWIGHT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1197
Practice Address - Country:US
Practice Address - Phone:559-789-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily