Individual provider Active NPI

Guida Quiambao Velasco, CLS

  • Medical Technologist
  • Elk Grove, CA
National Provider Identifier
1497615033
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
MTA40676 Issued in CA
Practice address
9559 Lazy Saddle Way
Elk Grove, CA 95624-6001
Phone
(916) 829-4117
Fax
(916) 236-3021
NPI assigned
Nov 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X MTA40676 CA Primary

Addresses

Primary practice location

9559 Lazy Saddle Way
Elk Grove, CA 95624-6001

Mailing address

9559 Lazy Saddle Way
Elk Grove, CA 95624-6001
Phone (916) 829-4117

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

State licenses

LicenseStateTypeSpecialty
MTA40676CAMDMedical Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jannat Q1 Inc CurrentSince Nov 24, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1497615033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9559 LAZY SADDLE WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956246001",
            "telephone_number": "916-829-4117",
            "fax_number": "916-236-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9559 LAZY SADDLE WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956246001",
            "telephone_number": "916-829-4117",
            "fax_number": "916-236-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "GUIDA",
        "middle_name": "QUIAMBAO",
        "name_prefix": "Mrs.",
        "credential": "CLS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "CA",
            "license": "MTA40676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.