Provider Demographics
NPI:1194370866
Name:CEPEDA, NORA GUZMAN
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:GUZMAN
Last Name:CEPEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:GUZMAN
Other - Last Name:ENCARNACION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:474 S CITRUS AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-4733
Mailing Address - Country:US
Mailing Address - Phone:626-858-9500
Mailing Address - Fax:
Practice Address - Street 1:474 S CITRUS AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-4733
Practice Address - Country:US
Practice Address - Phone:626-858-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)