Healthcare Provider Details

I. General information

NPI: 1548579055
Provider Name (Legal Business Name): JAZMIN GUZMAN LMFT, PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2010
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 PARKMOOR AVE
SAN JOSE CA
95128-2407
US

IV. Provider business mailing address

9036 MISSION BLVD # 1022
RIVERSIDE CA
92509-2816
US

V. Phone/Fax

Practice location:
  • Phone: 408-282-0402
  • Fax:
Mailing address:
  • Phone: 951-708-1822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT127065
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: