Healthcare Provider Details

I. General information

NPI: 1124951298
Provider Name (Legal Business Name): HAZEL JOYCE BUENAVENTURA DE GUZMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9608 VAN NUYS BLVD
PANORAMA CITY CA
91402-1000
US

IV. Provider business mailing address

25228 GOLDEN MAPLE DR
SANTA CLARITA CA
91387-1461
US

V. Phone/Fax

Practice location:
  • Phone: 213-804-5665
  • Fax:
Mailing address:
  • Phone: 213-804-5665
  • Fax: 661-367-4038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038782
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: