Healthcare Provider Details

I. General information

NPI: 1689198673
Provider Name (Legal Business Name): YENY ALEXANDRA CRUZ GUARIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YENY ALEXANDRA GUARIN

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 PARAMOUNT BLVD SPC 89
PICO RIVERA CA
90660-6086
US

IV. Provider business mailing address

PO BOX 1904
MONTEBELLO CA
90640-7904
US

V. Phone/Fax

Practice location:
  • Phone: 323-320-1183
  • Fax:
Mailing address:
  • Phone: 323-320-1183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: