Provider Demographics
NPI:1952950693
Name:EMPLEO, ROXANNE GUZMAN (PTA)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:GUZMAN
Last Name:EMPLEO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 N FRESNO ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2976
Mailing Address - Country:US
Mailing Address - Phone:559-438-4300
Mailing Address - Fax:
Practice Address - Street 1:201 S MADERA AVE STE 100
Practice Address - Street 2:
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-1129
Practice Address - Country:US
Practice Address - Phone:559-846-6336
Practice Address - Fax:559-846-3344
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA50229225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant