MEDICARE: GUAJOME PARK ACADEMY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1225980303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUAJOME PARK ACADEMY

Provider Business Mailing Address
First Line	:	2000 N SANTA FE AVE
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92083-1534
Country	:	US
Telephone Number	:	760-631-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 N SANTA FE AVE
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92083-1534
Country	:	US
Telephone Number	:	760-631-8500
Fax Number	:

Authorized Official
Title or Position	:	DEVELOPMENT SPECIALIST
Name	:	ADRINA ITZAINA
Credential	:
Telephone Number	:	760-631-8500

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “GUAJOME PARK ACADEMY ” Practice Location

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