Healthcare Provider Details

I. General information

NPI: 1942164769
Provider Name (Legal Business Name): RAYVEN SHERLEY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAYVEN SHERLEY GUZMAN MS

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 STANFORD AVE
LOS ANGELES CA
90021-1847
US

IV. Provider business mailing address

835 STANFORD AVE
LOS ANGELES CA
90021-1847
US

V. Phone/Fax

Practice location:
  • Phone: 213-896-2640
  • Fax:
Mailing address:
  • Phone: 213-896-2640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: