Healthcare Provider Details

I. General information

NPI: 1326954959
Provider Name (Legal Business Name): AVERIE-ALICE GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 E 3RD ST
LOS ANGELES CA
90063-2935
US

IV. Provider business mailing address

3434 E 3RD ST
LOS ANGELES CA
90063-2935
US

V. Phone/Fax

Practice location:
  • Phone: 626-614-6005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number93559
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: