Provider Demographics
NPI:1043874894
Name:GUZMAN, PATRICIA ANTOINETTE (BS)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANTOINETTE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:ANTOINETTE
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:326 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:326 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2515
Practice Address - Country:US
Practice Address - Phone:626-812-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician