Healthcare Provider Details

I. General information

NPI: 1538911326
Provider Name (Legal Business Name): NATHALIE CHRISTINE DE GUZMAN FNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 VENTURA CANYON AVE
PANORAMA CITY CA
91402-6312
US

IV. Provider business mailing address

17317 LOS ALIMOS ST
GRANADA HILLS CA
91344-4748
US

V. Phone/Fax

Practice location:
  • Phone: 818-375-2000
  • Fax:
Mailing address:
  • Phone: 818-294-2216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number95029806
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number846718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: