Provider Demographics
NPI:1538911326
Name:DE GUZMAN, NATHALIE CHRISTINE (FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:NATHALIE
Middle Name:CHRISTINE
Last Name:DE GUZMAN
Suffix:
Gender:F
Credentials:FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17317 LOS ALIMOS ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4748
Mailing Address - Country:US
Mailing Address - Phone:818-294-2216
Mailing Address - Fax:
Practice Address - Street 1:10316 WOODLEY AVE
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6916
Practice Address - Country:US
Practice Address - Phone:818-368-5651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029806363LP2300X
CA846718163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care