Healthcare Provider Details

I. General information

NPI: 1336083609
Provider Name (Legal Business Name): GEGUIENTO PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 TREAT BLVD STE 100
WALNUT CREEK CA
94598-1099
US

IV. Provider business mailing address

1511 TREAT BLVD STE 100
WALNUT CREEK CA
94598-1099
US

V. Phone/Fax

Practice location:
  • Phone: 925-949-8911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LLOYD VINCENT GEGUIENTO
Title or Position: PRESIDENT
Credential: PT
Phone: 332-238-7085