Provider Demographics
NPI:1871486647
Name:DE GUZMAN, SANDI (FNP)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:
Last Name:DE GUZMAN
Suffix:
Gender:X
Credentials:FNP
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:
Other - Last Name:KYAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1351 BROOKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4009
Mailing Address - Country:US
Mailing Address - Phone:925-391-4991
Mailing Address - Fax:
Practice Address - Street 1:1351 BROOKVIEW DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4009
Practice Address - Country:US
Practice Address - Phone:925-391-4991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily