Provider Demographics
NPI:1548579055
Name:GUZMAN, JAZMIN (LMFT, PSY D)
Entity Type:Individual
Prefix:DR
First Name:JAZMIN
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:LMFT, PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9036 MISSION BLVD # 1022
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92509-2816
Mailing Address - Country:US
Mailing Address - Phone:951-708-1822
Mailing Address - Fax:
Practice Address - Street 1:1555 PARKMOOR AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2407
Practice Address - Country:US
Practice Address - Phone:408-282-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TF0200X, 101YM0800X
CALMFT127065106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist