MEDICARE: LUIS GUIZAR M.A., LPC

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	101YM0800X	Mental Health Counselor	APCC18370	CA

General Provider Information

NPI Number	:	1215405121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS GUIZAR M.A., LPC

Provider Business Mailing Address
First Line	:	1932 E DEERE AVE STE 240
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5716
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1932 E DEERE AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5735
Country	:	US
Telephone Number	:	714-926-6058
Fax Number	:

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

Provider Enumeration Date	:	11/08/2018
Last Update Date	:	06/08/2026

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