Healthcare Provider Details

I. General information

NPI: 1063230977
Provider Name (Legal Business Name): ARACELI GUZMAN SUDRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 HARRIS AVE STE A
SACRAMENTO CA
95838-3249
US

IV. Provider business mailing address

1190 WILLOW GLEN DR
YUBA CITY CA
95991-1523
US

V. Phone/Fax

Practice location:
  • Phone: 916-649-6793
  • Fax:
Mailing address:
  • Phone: 916-230-1678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16431
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: