Healthcare Provider Details

I. General information

NPI: 1467102897
Provider Name (Legal Business Name): LLOYD VINCENT GEGUIENTO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
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

3107 DEL OCEANO DR
LAFAYETTE CA
94549-2004
US

V. Phone/Fax

Practice location:
  • Phone: 332-238-7085
  • Fax:
Mailing address:
  • Phone: 332-238-7085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT309314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: