Healthcare Provider Details

I. General information

NPI: 1245115179
Provider Name (Legal Business Name): ANDREA GUZMAN DELGADILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39650 MISSION BLVD
FREMONT CA
94539-3000
US

IV. Provider business mailing address

PO BOX 745
DIABLO CA
94528-0745
US

V. Phone/Fax

Practice location:
  • Phone: 844-262-8466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: