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General NPI Number Information
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NPI Number | 1538699236
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Entity Type | Individual
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Provider Name | CHARINETTE DEE GUERRERO GAMBOA FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 13300 NEW AIRPORT RD
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City | AUBURN
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State | CA
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Zip | 95602-7407
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Country | US
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Telephone | 530-889-8780
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Fax | 530-889-8781
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Provider Business Mailing Address
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Address Line | 13300 NEW AIRPORT RD
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City | AUBURN
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State | CA
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Zip | 95602-7407
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Country | US
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Telephone | 530-889-8780
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Fax | 530-889-8781
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95013188
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 55892
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95013188
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License Number State | CA
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