Healthcare Provider Details

I. General information

NPI: 1437084308
Provider Name (Legal Business Name): JARYLYNN MARIEL DE GUZMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 GROSSMONT CENTER DR
LA MESA CA
91942-3019
US

IV. Provider business mailing address

272 ZORIA FARMS LN
SAN JOSE CA
95127-1884
US

V. Phone/Fax

Practice location:
  • Phone: 619-740-4452
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: