Healthcare Provider Details

I. General information

NPI: 1659280618
Provider Name (Legal Business Name): STEPHANY ORTIZ GUZMAN MSW, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANY ORTIZ ANDRADE MSW PPS

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 E ST
MARYSVILLE CA
95901-4825
US

IV. Provider business mailing address

1104 E ST
MARYSVILLE CA
95901-4825
US

V. Phone/Fax

Practice location:
  • Phone: 530-749-4005
  • Fax:
Mailing address:
  • Phone: 530-749-4005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number230223427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: