Provider Demographics
NPI:1861812240
Name:ARTEAGA, GUILLERMINA
Entity type:Individual
Prefix:
First Name:GUILLERMINA
Middle Name:
Last Name:ARTEAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MINA
Other - Middle Name:
Other - Last Name:ARTEAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11260 ROXABEL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-2444
Mailing Address - Country:US
Mailing Address - Phone:562-324-8696
Mailing Address - Fax:
Practice Address - Street 1:11260 ROXABEL ST
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-2444
Practice Address - Country:US
Practice Address - Phone:562-324-8696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA24412355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant