Individual provider Active NPI

Guadalupe Chabriel, AGPCNP

  • Gerontology Nurse Practitioner
  • Petaluma, CA
National Provider Identifier
1003773532
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95038130 Issued in CA
Practice address
108 Lynch Creek Way Ste 3
Petaluma, CA 94954-2310
Phone
(707) 303-8350
NPI assigned
Jan 7, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95038130 CA Primary

Addresses

Primary practice location

108 Lynch Creek Way Ste 3
Petaluma, CA 94954-2310

Mailing address

85 W 8TH St Apt 405
Santa Rosa, CA 95401-5589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260205002846 CA Practitioner - Nurse Practitioner 7719466184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

108 Lynch Creek Way
Suite 3
Petaluma, CA 94954-2310
Phone (707) 763-7403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95038130CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Feb 1, 2026 Accepting new patients
Providence Medical Foundation CurrentSince Feb 1, 2026 Accepting new patients

Locations

108 Lynch Creek Way
Ste 3
Petaluma, CA 94954
Phone (707) 762-5078

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1003773532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W 8TH ST APT 405",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LYNCH CREEK WAY STE 3",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542310",
            "telephone_number": "707-303-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHABRIEL",
        "first_name": "GUADALUPE",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95038130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.