Healthcare Provider Details

I. General information

NPI: 1851203772
Provider Name (Legal Business Name): LILLIANA MARIE GUARDADO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 PANAMA ST
HAYWARD CA
94545-4698
US

IV. Provider business mailing address

31709 VALLEY FORGE ST
HAYWARD CA
94544-8135
US

V. Phone/Fax

Practice location:
  • Phone: 510-723-3180
  • Fax:
Mailing address:
  • Phone: 510-259-8617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberRPE22359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: