Healthcare Provider Details

I. General information

NPI: 1013349919
Provider Name (Legal Business Name): CASEY LYNN GUIDI WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 VALE TERRACE DR # CA92084
VISTA CA
92084-5218
US

IV. Provider business mailing address

1328 S MISSION RD
FALLBROOK CA
92028-4006
US

V. Phone/Fax

Practice location:
  • Phone: 760-631-5000
  • Fax:
Mailing address:
  • Phone: 760-451-4720
  • Fax: 760-451-4700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number830455
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95014526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: