Healthcare Provider Details

I. General information

NPI: 1255286779
Provider Name (Legal Business Name): BRUCE GUU PMHNP, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 N ST STE N #4756
SACRAMENTO CA
95816-5712
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 562-265-9722
  • Fax:
Mailing address:
  • Phone: 562-265-9722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95038920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: