Healthcare Provider Details

I. General information

NPI: 1073436523
Provider Name (Legal Business Name): ROBERTO A GUZMAN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E KERN AVE PMB 1024
TULARE CA
93274-4033
US

IV. Provider business mailing address

131 E KERN AVE PMB 1024
TULARE CA
93274-4033
US

V. Phone/Fax

Practice location:
  • Phone: 559-331-8905
  • Fax:
Mailing address:
  • Phone: 559-331-8905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: