Provider Demographics
NPI:1215398979
Name:GUZMAN, SILVIA
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:GUZMAN
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 1:130 E 77TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-2528
Mailing Address - Country:US
Mailing Address - Phone:323-807-5219
Mailing Address - Fax:626-214-1474
Practice Address - Street 1:555 SOUTH SECOND AVENUE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723
Practice Address - Country:US
Practice Address - Phone:626-214-1494
Practice Address - Fax:626-214-1474
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA239662164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse