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General NPI Number Information
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NPI Number | 1588190664
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Entity Type | Individual
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Provider Name | VANESSA GUZMAN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 82151 AVENUE 42 STE 100
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City | INDIO
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State | CA
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Zip | 92203-9313
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Country | US
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Telephone | 442-224-6968
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Fax |
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Provider Business Mailing Address
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Address Line | 8780 19TH ST # 300
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City | ALTA LOMA
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State | CA
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Zip | 91701-4608
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Country | US
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Telephone | 617-528-9406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA54785
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License Number State | CA
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