Provider Demographics
NPI:1174340269
Name:GUANDIQUE, BIANCA
Entity type:Individual
Prefix:MS
First Name:BIANCA
Middle Name:
Last Name:GUANDIQUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 HARTFORD ST SE APT 204
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7971
Mailing Address - Country:US
Mailing Address - Phone:202-763-9895
Mailing Address - Fax:
Practice Address - Street 1:2419 18TH PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6315
Practice Address - Country:US
Practice Address - Phone:202-640-0824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant