Healthcare Provider Details

I. General information

NPI: 1891687489
Provider Name (Legal Business Name): STEPHANIE ESCOTO GUZMAN SLPA 2757
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8660 BRENTWOOD BLVD
BRENTWOOD CA
94513-5655
US

IV. Provider business mailing address

675 WINDING CREEK TER
BRENTWOOD CA
94513-1831
US

V. Phone/Fax

Practice location:
  • Phone: 925-626-7474
  • Fax:
Mailing address:
  • Phone: 914-527-1383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2757
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: