Healthcare Provider Details

I. General information

NPI: 1770492480
Provider Name (Legal Business Name): GUILLERMA (EMMA) ANDERSON-SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMMA ANDERSON

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 AZALEA AVE STE A
REDDING CA
96002-0217
US

IV. Provider business mailing address

670 AZALEA AVE STE A
REDDING CA
96002-0217
US

V. Phone/Fax

Practice location:
  • Phone: 530-410-0157
  • Fax:
Mailing address:
  • Phone: 530-410-0157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: