Healthcare Provider Details

I. General information

NPI: 1285042358
Provider Name (Legal Business Name): MAKENZIE GUYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3738 WALNUT AVE STE 156
CARMICHAEL CA
95608-3054
US

IV. Provider business mailing address

3738 WALNUT AVE STE 156
CARMICHAEL CA
95608-3054
US

V. Phone/Fax

Practice location:
  • Phone: 916-971-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number19586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: