Healthcare Provider Details

I. General information

NPI: 1780528356
Provider Name (Legal Business Name): ALYSSA NICOLE GUZMAN LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 WALNUT AVE
CHINO CA
91710-2611
US

IV. Provider business mailing address

14583 MCKENDREE AVE
CHINO CA
91710-6988
US

V. Phone/Fax

Practice location:
  • Phone: 909-306-7278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number790
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: