Provider Demographics
NPI:1316837743
Name:BLAS GUZMAN, KARLA GUADALUPE (RDH)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:GUADALUPE
Last Name:BLAS GUZMAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 CAROLYN CT
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4415
Mailing Address - Country:US
Mailing Address - Phone:831-319-6132
Mailing Address - Fax:
Practice Address - Street 1:452 CAROLYN CT
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4415
Practice Address - Country:US
Practice Address - Phone:831-319-6132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH37435124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist