Healthcare Provider Details

I. General information

NPI: 1982424594
Provider Name (Legal Business Name): GABRIELLA ALEXANDRA GUZMAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33315 SANTIAGO RD
ACTON CA
93510-1416
US

IV. Provider business mailing address

PO BOX 1094
ACTON CA
93510-7094
US

V. Phone/Fax

Practice location:
  • Phone: 661-269-2316
  • Fax:
Mailing address:
  • Phone: 818-723-5075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: