Provider Demographics
NPI:1952926289
Name:GUEVARRA, BERNADET VIRAY (FNP)
Entity Type:Individual
Prefix:
First Name:BERNADET
Middle Name:VIRAY
Last Name:GUEVARRA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BERNADET
Other - Middle Name:DE LEON
Other - Last Name:VIRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:995 HIGATE DR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4259
Mailing Address - Country:US
Mailing Address - Phone:650-550-4267
Mailing Address - Fax:650-550-4267
Practice Address - Street 1:995 HIGATE DR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4259
Practice Address - Country:US
Practice Address - Phone:650-576-0836
Practice Address - Fax:650-550-4267
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555880363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily