Healthcare Provider Details

I. General information

NPI: 1336065788
Provider Name (Legal Business Name): ALMAS BAILARINAS DANCING SOULS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5427 ROSEMEAD BLVB
SAN GABRIEL CA
91776-2212
US

IV. Provider business mailing address

5427 ROSEMEAD BLVB
SAN GABRIEL CA
91776-2212
US

V. Phone/Fax

Practice location:
  • Phone: 323-517-1990
  • Fax:
Mailing address:
  • Phone: 323-517-1990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SARA GUEVARA
Title or Position: CEO
Credential: LMFT
Phone: 323-517-1990