Provider Demographics
NPI:1790150936
Name:URRUTIA, LINZY (PA-C)
Entity Type:Individual
Prefix:
First Name:LINZY
Middle Name:
Last Name:URRUTIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINZY
Other - Middle Name:
Other - Last Name:BRENEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1780 E BULLARD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5861
Mailing Address - Country:US
Mailing Address - Phone:559-485-8500
Mailing Address - Fax:559-485-8500
Practice Address - Street 1:1780 E BULLARD AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5861
Practice Address - Country:US
Practice Address - Phone:559-485-8500
Practice Address - Fax:559-485-8500
Is Sole Proprietor?:No
Enumeration Date:2015-12-13
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical