Healthcare Provider Details

I. General information

NPI: 1972010700
Provider Name (Legal Business Name): STEVEN GUZOWSKI BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18008 SKY PARK CIR STE 110
IRVINE CA
92614
US

IV. Provider business mailing address

18008 SKY PARK CIR STE 110
IRVINE CA
92614-6434
US

V. Phone/Fax

Practice location:
  • Phone: 949-474-1493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-31074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: