Healthcare Provider Details

I. General information

NPI: 1265422695
Provider Name (Legal Business Name): RICHARD VICTOR GUZZETTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 5TH ST STE B
CLOVIS CA
93612-1058
US

IV. Provider business mailing address

312 5TH ST STE B
CLOVIS CA
93612-1058
US

V. Phone/Fax

Practice location:
  • Phone: 559-285-5723
  • Fax: 559-323-4498
Mailing address:
  • Phone: 559-285-5723
  • Fax: 559-323-4498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG40600
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG40600
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberG40600
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberG40600
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: