Healthcare Provider Details

I. General information

NPI: 1972102515
Provider Name (Legal Business Name): MONICA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2020
Last Update Date: 10/24/2020
Certification Date: 10/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

IV. Provider business mailing address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

V. Phone/Fax

Practice location:
  • Phone: 408-665-4908
  • Fax: 408-842-0383
Mailing address:
  • Phone: 408-665-4908
  • Fax: 408-842-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: