Healthcare Provider Details

I. General information

NPI: 1659285310
Provider Name (Legal Business Name): SIENNA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 SCENIC DR
MODESTO CA
95350-6137
US

IV. Provider business mailing address

3017 ESTATE DR
STOCKTON CA
95209-1177
US

V. Phone/Fax

Practice location:
  • Phone: 800-380-9366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number24306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: