Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT23348 | CA |
NPI | 1003057233 |
---|---|
Provider Name | Joley Ann Guevara |
First Address | Dublin, CA 94568 |
Second Address | Walnut Creek, CA 94598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2009 |
Last Update Date | 18/03/2009 |