Healthcare Provider Details

I. General information

NPI: 1023544202
Provider Name (Legal Business Name): MRS. PATRICIA AYALA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. PATRICIA AYALA-GUZMAN

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E SAINT ANDREW PL
SANTA ANA CA
92705-4933
US

IV. Provider business mailing address

1700 E SAINT ANDREW PL
SANTA ANA CA
92705-4933
US

V. Phone/Fax

Practice location:
  • Phone: 714-687-6755
  • Fax:
Mailing address:
  • Phone: 714-687-6755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: