Healthcare Provider Details

I. General information

NPI: 1760358170
Provider Name (Legal Business Name): KARLA SOFIA BUENROSTRO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 COLORADO AVE
TURLOCK CA
95382-2013
US

IV. Provider business mailing address

2330 COLORADO AVE
TURLOCK CA
95382-2013
US

V. Phone/Fax

Practice location:
  • Phone: 209-250-2530
  • Fax: 209-633-3433
Mailing address:
  • Phone: 209-250-2530
  • Fax: 209-633-3433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95037208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: