Provider Demographics
NPI:1255085411
Name:GUARDADO, ARACELI
Entity type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:GUARDADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 CAJON ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5955
Mailing Address - Country:US
Mailing Address - Phone:909-307-5777
Mailing Address - Fax:909-307-5776
Practice Address - Street 1:440 CAJON ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5955
Practice Address - Country:US
Practice Address - Phone:909-307-5777
Practice Address - Fax:909-307-5776
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker