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NPI Code Detail

MEDICARE: ANTWANETTE DE GUZMAN

MEDICARE: ANTWANETTE DE 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1932066115
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTWANETTE DE GUZMAN
Provider Business Mailing Address
First Line : 39420 LIBERTY ST STE 150
Second Line :
City : FREMONT
State : CA
Zip : 94538-2284
Country : US
Telephone Number : 510-794-5155
Fax Number :
Provider Business Practice Location Address
First Line : 39420 LIBERTY ST STE 150
Second Line :
City : FREMONT
State : CA
Zip : 94538-2284
Country : US
Telephone Number : 510-794-5155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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Directions to “ ANTWANETTE DE GUZMAN ” Practice Location

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