Provider Demographics
NPI:1306398326
Name:GUZMAN, ASHLEE
Entity Type:Individual
Prefix:
First Name:ASHLEE
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 1:425 W FOOTHILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-5302
Mailing Address - Country:US
Mailing Address - Phone:626-351-0734
Mailing Address - Fax:
Practice Address - Street 1:425 W FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-5302
Practice Address - Country:US
Practice Address - Phone:626-513-0734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237700000X
CAHA8155237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1306398326Medicaid