Healthcare Provider Details

I. General information

NPI: 1083189807
Provider Name (Legal Business Name): ANGELINA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E 1ST ST
SANTA ANA CA
92705-4007
US

IV. Provider business mailing address

13459 1/4 FILMORE ST
PACOIMA CA
91331-2904
US

V. Phone/Fax

Practice location:
  • Phone: 714-542-3581
  • Fax:
Mailing address:
  • Phone: 714-818-5895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: