Provider Demographics
NPI:1982424594
Name:GUZMAN, GABRIELLA ALEXANDRA (DC)
Entity type:Individual
Prefix:DR
First Name:GABRIELLA
Middle Name:ALEXANDRA
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1094
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:CA
Mailing Address - Zip Code:93510-7094
Mailing Address - Country:US
Mailing Address - Phone:818-723-5075
Mailing Address - Fax:
Practice Address - Street 1:33315 SANTIAGO RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:CA
Practice Address - Zip Code:93510-1416
Practice Address - Country:US
Practice Address - Phone:661-269-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC37105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor