Healthcare Provider Details

I. General information

NPI: 1891898995
Provider Name (Legal Business Name): EVANGELIN GUZMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD STE 202
SALINAS CA
93906-3127
US

IV. Provider business mailing address

1441 CONSTITUTION BLVD STE 202
SALINAS CA
93906-3127
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036058102
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: