Individual provider Active NPI

Jenna De Guzman, OTD, OTR/L

  • Occupational Therapist
  • Dalton Gardens, ID
National Provider Identifier
1538815469
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0T2531 Issued in ID
Practice address
6270 N Government Way
Dalton Gardens, ID 83815-9214
Phone
(208) 666-0611
NPI assigned
Mar 1, 2022
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 0T2531 ID Primary

Addresses

Primary practice location

6270 N Government Way
Dalton Gardens, ID 83815-9214

Mailing address

1902 E 63Rd Ave
Spokane, WA 99223-8403
Phone (208) 661-9844

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
0T2531IDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Healthcare for Kids Inc. CurrentSince Mar 6, 2022 Accepting new patients

Locations

6270 N Government Way
Dalton Gardens, ID 83815
Phone (208) 664-0566

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1538815469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 E 63RD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992238403",
            "telephone_number": "208-661-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6270 N GOVERNMENT WAY",
            "city": "DALTON GARDENS",
            "state": "ID",
            "postal_code": "838159214",
            "telephone_number": "208-666-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "JENNA",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "0T2531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton Gardens, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.