Provider Demographics
NPI:1659443174
Name:TRELLES, GUADALUPE VELEZ (DC)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:VELEZ
Last Name:TRELLES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MEDICINE
Other - Middle Name:WOMAN
Other - Last Name:CHIROPRACTIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:56872 29 PALMS HWY
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2939
Mailing Address - Country:US
Mailing Address - Phone:760-365-4415
Mailing Address - Fax:760-365-0184
Practice Address - Street 1:56872 29 PALMS HWY
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2939
Practice Address - Country:US
Practice Address - Phone:760-365-4415
Practice Address - Fax:760-365-0184
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15455111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation