Healthcare Provider Details

I. General information

NPI: 1740632082
Provider Name (Legal Business Name): MARIA ANA GUZMAN CAC I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8380 ZUNI ST STE 205
DENVER CO
80221-4689
US

IV. Provider business mailing address

4927 W MISSISSIPPI AVE
DENVER CO
80219-3102
US

V. Phone/Fax

Practice location:
  • Phone: 303-823-1988
  • Fax:
Mailing address:
  • Phone: 303-929-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0007412
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: