Provider Demographics
NPI:1114413788
Name:GUZMAN, PAULA MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 CASTLEGATE LN
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-1636
Mailing Address - Country:US
Mailing Address - Phone:909-809-6865
Mailing Address - Fax:909-793-5987
Practice Address - Street 1:1955 CASTLEGATE LN
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-1636
Practice Address - Country:US
Practice Address - Phone:909-809-6865
Practice Address - Fax:909-793-5987
Is Sole Proprietor?:No
Enumeration Date:2018-07-07
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016004363L00000X
CA544665163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse