Healthcare Provider Details

I. General information

NPI: 1568977221
Provider Name (Legal Business Name): RIGOBERTO GUZMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RIGOBERTO GUZMAN MSW

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3569 LEXINGTON AVE
EL MONTE CA
91731-2607
US

IV. Provider business mailing address

3569 LEXINGTON AVE
EL MONTE CA
91731-2607
US

V. Phone/Fax

Practice location:
  • Phone: 626-453-3399
  • Fax:
Mailing address:
  • Phone: 626-453-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW110402
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW110402
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: