Provider Demographics
NPI:1457389215
Name:GUERRA, CYNTHIA M (MSN FNP C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:GUERRA
Suffix:
Gender:F
Credentials:MSN FNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-3012
Mailing Address - Country:US
Mailing Address - Phone:559-896-2624
Mailing Address - Fax:559-896-3235
Practice Address - Street 1:2511 LOGAN ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3012
Practice Address - Country:US
Practice Address - Phone:559-896-2624
Practice Address - Fax:559-896-3235
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14892363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q34205Medicare UPIN
CAZZZ32333ZMedicare ID - Type Unspecified