Provider Demographics
NPI:1093025546
Name:GUZMAN, MARIANA (LMFT, LAADC)
Entity Type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:LMFT, LAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BLISS CIR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-3594
Mailing Address - Country:US
Mailing Address - Phone:760-978-8300
Mailing Address - Fax:888-292-0251
Practice Address - Street 1:410 S MELROSE DR STE 105
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6607
Practice Address - Country:US
Practice Address - Phone:760-978-8300
Practice Address - Fax:888-292-0251
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALR02601116101YA0400X
CA80015101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093025546Medicaid
CA1093025546OtherMEDI-CAL