MEDICARE: MRS. LINDA FAY KUTZBACH FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	190049	CA
2	363L00000X	Nurse Practitioner	10245	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	190049	OTHER	CA	RN LICENSE

General Provider Information

NPI Number	:	1033162409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA FAY KUTZBACH FNP

Provider Business Mailing Address
First Line	:	16111 PLUMMER ST
Second Line	:	BLDG 99
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-2036
Country	:	US
Telephone Number	:	818-891-7711
Fax Number	:	818-895-5817

Provider Business Practice Location Address
First Line	:	16111 PLUMMER ST
Second Line	:	BLDG 99
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-2036
Country	:	US
Telephone Number	:	818-891-7711
Fax Number	:	818-895-5817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	09/11/2025

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