Healthcare Provider Details

I. General information

NPI: 1740975234
Provider Name (Legal Business Name): ANDREA GUZMAN-QUATERNIK CAMTC CERT#51047
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7624 PAINTER AVE STE 200
WHITTIER CA
90602-2328
US

IV. Provider business mailing address

1475 W 24TH ST
UPLAND CA
91784-1020
US

V. Phone/Fax

Practice location:
  • Phone: 562-789-8661
  • Fax:
Mailing address:
  • Phone: 626-977-8717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number51047
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: