Provider Demographics
NPI:1437775418
Name:GARDUCE, KARSTEN MICHELLO V SR (FNP)
Entity Type:Individual
Prefix:MR
First Name:KARSTEN MICHELLO
Middle Name:V
Last Name:GARDUCE
Suffix:SR
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2635 NAPA ST UNIT 1766
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5679
Mailing Address - Country:US
Mailing Address - Phone:510-387-1993
Mailing Address - Fax:
Practice Address - Street 1:738 BANCROFT RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1593
Practice Address - Country:US
Practice Address - Phone:925-932-0321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010860363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily