Healthcare Provider Details

I. General information

NPI: 1992622369
Provider Name (Legal Business Name): ELIZABETH I. GUZMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1293 6TH ST
COACHELLA CA
92236-1707
US

IV. Provider business mailing address

1293 6TH ST
COACHELLA CA
92236-1707
US

V. Phone/Fax

Practice location:
  • Phone: 760-391-5151
  • Fax:
Mailing address:
  • Phone: 760-391-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: