Healthcare Provider Details

I. General information

NPI: 1760851752
Provider Name (Legal Business Name): ARLENE GUZMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2015
Last Update Date: 09/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S GLENDORA AVE
WEST COVINA CA
91790-3001
US

IV. Provider business mailing address

420 S GLENDORA AVE
WEST COVINA CA
91790-3001
US

V. Phone/Fax

Practice location:
  • Phone: 626-919-4333
  • Fax: 626-918-0597
Mailing address:
  • Phone: 626-919-4333
  • Fax: 626-918-0597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCSW64998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: