Provider Demographics
NPI:1326797317
Name:GUZMAN, LYNDA MICHELLE (RADT1)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:MICHELLE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:RADT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 FORANE ST
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-5724
Mailing Address - Country:US
Mailing Address - Phone:760-261-9889
Mailing Address - Fax:
Practice Address - Street 1:225 BARSTOW RD
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-2903
Practice Address - Country:US
Practice Address - Phone:760-255-1083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)