Healthcare Provider Details

I. General information

NPI: 1801751581
Provider Name (Legal Business Name): BRITTNAY UALENA LEON-GUERRERO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 MAIN ST
EL SEGUNDO CA
90245-3814
US

IV. Provider business mailing address

12 CORALTREE LN
ROLLING HILLS ESTATES CA
90274-4819
US

V. Phone/Fax

Practice location:
  • Phone: 310-648-3167
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309130
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: