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General NPI Number Information
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NPI Number | 1730469735
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Entity Type | Individual
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Provider Name | GLORIA HOLGUIN
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Gender | Female
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 10788 GALA AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-7513
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Country | US
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Telephone | 323-702-2694
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Fax | 626-335-5989
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Provider Business Mailing Address
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Address Line | PO BOX 8312
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City | ALTA LOMA
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State | CA
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Zip | 91701-0312
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Country | US
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Telephone | 323-702-2694
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 77725
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License Number State | CA
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