Healthcare Provider Details

I. General information

NPI: 1962225508
Provider Name (Legal Business Name): YAINYT OLVERA GUERRERO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 E WALNUT ST STE 155
PASADENA CA
91101-1588
US

IV. Provider business mailing address

926 SAED ST
POMONA CA
91768-2027
US

V. Phone/Fax

Practice location:
  • Phone: 626-408-0010
  • Fax:
Mailing address:
  • Phone: 909-282-9856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number37104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: