Healthcare Provider Details

I. General information

NPI: 1265893614
Provider Name (Legal Business Name): GRACIELA RENE GUILLEN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2016
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E ORANGETHORPE AVE
PLACENTIA CA
92870-5302
US

IV. Provider business mailing address

8610 OCEAN VIEW AVE
WHITTIER CA
90605-1508
US

V. Phone/Fax

Practice location:
  • Phone: 714-986-7000
  • Fax: 714-524-3034
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number32198
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: