Provider Demographics
NPI:1356739833
Name:GUEVARRA, MARIA LEAH GALERO (PT)
Entity type:Individual
Prefix:
First Name:MARIA LEAH
Middle Name:GALERO
Last Name:GUEVARRA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19833 VIA KALBAN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2191
Mailing Address - Country:US
Mailing Address - Phone:323-638-6169
Mailing Address - Fax:
Practice Address - Street 1:19833 VIA KALBAN
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2191
Practice Address - Country:US
Practice Address - Phone:323-638-6169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist