Healthcare Provider Details

I. General information

NPI: 1972458834
Provider Name (Legal Business Name): ANGELA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18200 RINALDI PL
PORTER RANCH CA
91326-2551
US

IV. Provider business mailing address

5258 NEWCASTLE AVE APT 32
ENCINO CA
91316-3087
US

V. Phone/Fax

Practice location:
  • Phone: 818-916-0295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: