Healthcare Provider Details

I. General information

NPI: 1629902663
Provider Name (Legal Business Name): ERICA GUGIELMI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6135 KING RD STE B
LOOMIS CA
95650-8877
US

IV. Provider business mailing address

307 HERMAN CIR
AUBURN CA
95603-4156
US

V. Phone/Fax

Practice location:
  • Phone: 916-676-7405
  • Fax:
Mailing address:
  • Phone: 916-260-6708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: