Provider Demographics
NPI:1346429909
Name:GUINTO, SUSAN (LPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:GUINTO
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20461 E VIA VERDE ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-3713
Mailing Address - Country:US
Mailing Address - Phone:323-644-2030
Mailing Address - Fax:
Practice Address - Street 1:437 N HOOVER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-2306
Practice Address - Country:US
Practice Address - Phone:323-644-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29608167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician