Provider Demographics
NPI:1386407567
Name:GLORIA, RAINIER GUINGON (NP-C)
Entity type:Individual
Prefix:
First Name:RAINIER
Middle Name:GUINGON
Last Name:GLORIA
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26509 STARLING CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-8128
Mailing Address - Country:US
Mailing Address - Phone:323-401-5919
Mailing Address - Fax:
Practice Address - Street 1:26509 STARLING CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91387-8128
Practice Address - Country:US
Practice Address - Phone:323-401-5919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF01241476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty