Healthcare Provider Details

I. General information

NPI: 1750178174
Provider Name (Legal Business Name): GABRIELA CRISTINA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 GOLDEN CENTER DR STE E
PLACERVILLE CA
95667-6258
US

IV. Provider business mailing address

4340 GOLDEN CENTER DR STE E
PLACERVILLE CA
95667-6258
US

V. Phone/Fax

Practice location:
  • Phone: 209-588-9735
  • Fax: 530-622-2212
Mailing address:
  • Phone: 209-588-9735
  • Fax: 530-622-2212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number9113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: