Provider Demographics
NPI:1497935035
Name:GUINAN, LONDON ANASTACIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LONDON
Middle Name:ANASTACIA
Last Name:GUINAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TRESTLE PT
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8644
Mailing Address - Country:US
Mailing Address - Phone:510-612-0469
Mailing Address - Fax:
Practice Address - Street 1:801 TRESTLE PT
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8644
Practice Address - Country:US
Practice Address - Phone:510-612-0469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554003163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management