Provider Demographics
NPI:1669086989
Name:GUZMAN, TAELOR (RDN)
Entity type:Individual
Prefix:
First Name:TAELOR
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27400 ALTAMONT RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-4228
Mailing Address - Country:US
Mailing Address - Phone:469-432-7390
Mailing Address - Fax:
Practice Address - Street 1:13429 BRIARBROOK DR
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-5104
Practice Address - Country:US
Practice Address - Phone:469-432-7390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered