Healthcare Provider Details

I. General information

NPI: 1144914375
Provider Name (Legal Business Name): COURTNEY GUYTON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 W OLYMPIC BLVD STE 570
LOS ANGELES CA
90064-1536
US

IV. Provider business mailing address

11500 W OLYMPIC BLVD STE 570
LOS ANGELES CA
90064-1536
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-8400
  • Fax:
Mailing address:
  • Phone: 310-268-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95025680
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95330584
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: