Provider Demographics
NPI:1407915036
Name:GUZMAN, SHANNA LYNN (L AC)
Entity Type:Individual
Prefix:MISS
First Name:SHANNA
Middle Name:LYNN
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BEN LOMOND
Mailing Address - State:CA
Mailing Address - Zip Code:95005-9518
Mailing Address - Country:US
Mailing Address - Phone:831-246-1017
Mailing Address - Fax:
Practice Address - Street 1:621 WATER ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4146
Practice Address - Country:US
Practice Address - Phone:831-457-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA9864171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist