Provider Demographics
NPI:1104507466
Name:USI, MARIANNE GUINTU (NP)
Entity type:Individual
Prefix:MISS
First Name:MARIANNE
Middle Name:GUINTU
Last Name:USI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26894 SNOW CANYON CIR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4987
Mailing Address - Country:US
Mailing Address - Phone:909-343-9972
Mailing Address - Fax:
Practice Address - Street 1:26894 SNOW CANYON CIR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4987
Practice Address - Country:US
Practice Address - Phone:818-707-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95011934363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology