Individual
GUADALUPE GUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1950 MARKET ST, RIVERSIDE, CA 92501-1720
(909) 530-5900
Mailing address
1950 MARKET ST, RIVERSIDE, CA 92501-1720
(909) 530-5900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ACSW130461
CA
175T00000X
Peer Specialist
MPSS-PONYQE
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
12/08/2022
Last updated
06/03/2025
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