Healthcare Provider Details

I. General information

NPI: 1619866522
Provider Name (Legal Business Name): ALMA NARTATEZ FABRO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21231 OAKFORT AVE
CARSON CA
90745-1842
US

IV. Provider business mailing address

21231 OAKFORT AVE
CARSON CA
90745-1842
US

V. Phone/Fax

Practice location:
  • Phone: 310-972-8634
  • Fax:
Mailing address:
  • Phone: 310-972-8634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: