Healthcare Provider Details

I. General information

NPI: 1467075689
Provider Name (Legal Business Name): CATHERINE ANN GUTHRIE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2433 CENTRAL AVE STE 100
ALAMEDA CA
94501-6562
US

IV. Provider business mailing address

7999 GATEWAY BLVD STE 200
NEWARK CA
94560-1197
US

V. Phone/Fax

Practice location:
  • Phone: 510-521-2300
  • Fax: 510-521-7947
Mailing address:
  • Phone: 510-521-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95014560
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95014560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: