Individual
LYDIA GUILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18387 ASH ST, BLOOMINGTON, CA 92316-2601
(909) 543-7817
Mailing address
18387 ASH ST, BLOOMINGTON, CA 92316-2601
(909) 543-7817
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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