Healthcare Provider Details

I. General information

NPI: 1508721499
Provider Name (Legal Business Name): TREE OF LIFE FEEDING & SPEECH THERAPY CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3816 WOODRUFF AVE STE 102
LONG BEACH CA
90808-2145
US

IV. Provider business mailing address

3454 WOODRUFF AVE
LONG BEACH CA
90808-2735
US

V. Phone/Fax

Practice location:
  • Phone: 714-251-6515
  • Fax:
Mailing address:
  • Phone: 714-251-6515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIFFANY GUARDADO
Title or Position: OWNER
Credential: M.S. CCC-SLP, IBCLC
Phone: 714-251-6515