Healthcare Provider Details

I. General information

NPI: 1639559461
Provider Name (Legal Business Name): CLAIRE ALEXANDRA GUEVARA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2015
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 MARENGO ST
LOS ANGELES CA
90033-1352
US

IV. Provider business mailing address

11928 SIERRA SKY DR
WHITTIER CA
90601-1917
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-1000
  • Fax:
Mailing address:
  • Phone: 562-400-1119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA168831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: