Provider Demographics
NPI:1275332991
Name:GUTIERREZ, KARIZMA PATRICIA (FNP-C)
Entity type:Individual
Prefix:
First Name:KARIZMA
Middle Name:PATRICIA
Last Name:GUTIERREZ
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15538 BOW STRING ST
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-6715
Mailing Address - Country:US
Mailing Address - Phone:909-205-9403
Mailing Address - Fax:
Practice Address - Street 1:11833 AMETHYST RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-9221
Practice Address - Country:US
Practice Address - Phone:888-575-0609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033398363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care