Active NPI
Gabriella Guevara
- Optician
- Peoria, AZ
National Provider Identifier
1639964158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO003417
- Practice address
- 21655 N Lake Pleasant Pkwy
Peoria, AZ 85382-7436 - Phone
- (623) 537-4595
- Fax
- (623) 537-4972
- NPI assigned
- Apr 14, 2025
- Last updated
- Apr 14, 2025
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | LDO003417 | AZ | Primary |
Addresses
Primary practice location
21655 N Lake Pleasant Pkwy
Peoria, AZ 85382-7436
Mailing address
21655 N Lake Pleasant Pkwy
Peoria, AZ 85382-7436
Phone (623) 537-4595
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
| License | State | Type | Specialty |
|---|---|---|---|
| LDO003417 | AZ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744588800000",
"number": "1639964158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21655 N LAKE PLEASANT PKWY",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853827436",
"telephone_number": "623-537-4595",
"fax_number": "623-537-4972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21655 N LAKE PLEASANT PKWY",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853827436",
"telephone_number": "623-537-4595",
"fax_number": "623-537-4972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUEVARA",
"first_name": "GABRIELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-14",
"last_updated": "2025-04-14",
"certification_date": "2025-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AZ",
"license": "LDO003417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.