Healthcare Provider Details

I. General information

NPI: 1861805533
Provider Name (Legal Business Name): MR. LUIS ROBERTO GUZMAN ZAVALA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 ROSECRANS AVE FL 4
BELLFLOWER CA
90706-2246
US

IV. Provider business mailing address

9400 ROSECRANS AVE FL 4
BELLFLOWER CA
90706-2246
US

V. Phone/Fax

Practice location:
  • Phone: 562-807-6200
  • Fax: 562-461-4388
Mailing address:
  • Phone: 562-807-6200
  • Fax: 562-461-4388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT1343351
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: