Provider Demographics
NPI:1164867388
Name:GUO, JENNY
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W CESAR E CHAVEZ AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2104
Mailing Address - Country:US
Mailing Address - Phone:213-217-5300
Mailing Address - Fax:
Practice Address - Street 1:701 W CESAR E CHAVEZ AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2104
Practice Address - Country:US
Practice Address - Phone:213-217-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator