Active NPI
Olivia De Guzman, RN
- Adult Companion
- San Mateo, CA
National Provider Identifier
1104414051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- 415601054
- Practice address
- 3405 Leafwood CT
San Mateo, CA 94403-3949 - Phone
- (415) 609-4688
- NPI assigned
- Jan 6, 2021
- Last updated
- Jan 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | 415601054 | CA | Primary |
Addresses
Primary practice location
3405 Leafwood CT
San Mateo, CA 94403-3949
Mailing address
3405 Leafwood CT
San Mateo, CA 94403-3949
Phone (415) 609-4688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 415601054 | CA | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1104414051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3405 LEAFWOOD CT",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944033949",
"telephone_number": "415-609-4688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3405 LEAFWOOD CT",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944033949",
"telephone_number": "415-609-4688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE GUZMAN",
"first_name": "OLIVIA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-06",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "CA",
"license": "415601054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.