Healthcare Provider Details

I. General information

NPI: 1184101842
Provider Name (Legal Business Name): MISS CYNTHIA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 07/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 HARDY DR
WOODLAND CA
95776-5146
US

IV. Provider business mailing address

215 W BEAMER ST
WOODLAND CA
95695-2510
US

V. Phone/Fax

Practice location:
  • Phone: 916-403-2970
  • Fax:
Mailing address:
  • Phone: 530-405-2815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: