Healthcare Provider Details

I. General information

NPI: 1558931428
Provider Name (Legal Business Name): EVELYN NOHELLI GUZMAN-TARULA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RANCHO CAMINO DR FL 2
POMONA CA
91766-7030
US

IV. Provider business mailing address

907 N ELEANOR ST
POMONA CA
91767-4755
US

V. Phone/Fax

Practice location:
  • Phone: 909-618-0974
  • Fax:
Mailing address:
  • Phone: 909-541-9268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: