Provider Demographics
NPI:1467075689
Name:GUTHRIE, CATHERINE ANN (NP)
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:ANN
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7999 GATEWAY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1197
Mailing Address - Country:US
Mailing Address - Phone:510-521-2300
Mailing Address - Fax:
Practice Address - Street 1:2433 CENTRAL AVE STE 100
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6562
Practice Address - Country:US
Practice Address - Phone:510-521-2300
Practice Address - Fax:510-521-7947
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95014560363LF0000X
CA95014560363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF06192742OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS NATIONAL CERTIFICATION
CANP95014560OtherCALIFORNIA BOARD OF REGISTERED NURSING
CANPF95014560OtherNURSE PRACTITIONER FURNISHING LICENSE