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NPI Code Detail

MEDICARE: GUADALUPE MATIAS VERDUZCO

MEDICARE: GUADALUPE MATIAS VERDUZCO
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
1106S00000XBehavior TechnicianY7303194CA

General Provider Information

NPI Number : 1518734045
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUADALUPE MATIAS VERDUZCO
Provider Business Mailing Address
First Line : 5850 GRANITE PKWY
Second Line :
City : PLANO
State : TX
Zip : 75024-6748
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3840 ROSIN CT
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1639
Country : US
Telephone Number : 916-374-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2023
Last Update Date : 01/23/2026

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Directions to “ GUADALUPE MATIAS VERDUZCO ” Practice Location

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