MEDICARE: JESSICA SALDANA GUZMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1144786443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SALDANA GUZMAN

Provider Business Mailing Address
First Line	:	24910 LAS BRISAS RD STE 117
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-4035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24910 LAS BRISAS RD STE 117
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-4035
Country	:	US
Telephone Number	:	951-465-3664
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2019
Last Update Date	:	02/17/2025

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