Provider Demographics
NPI:1518598655
Name:GUZMAN, MICHELLE (SUDCC/MHCS 1)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:SUDCC/MHCS 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400K EMELINE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1976
Mailing Address - Country:US
Mailing Address - Phone:831-454-4900
Mailing Address - Fax:831-425-4916
Practice Address - Street 1:1400K EMELINE AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-1976
Practice Address - Country:US
Practice Address - Phone:831-425-4900
Practice Address - Fax:831-425-1847
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10335171M00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)