Provider Demographics
NPI:1568217586
Name:DE GUZMAN, MONALIZA PIMENTEL
Entity Type:Individual
Prefix:
First Name:MONALIZA
Middle Name:PIMENTEL
Last Name:DE GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 MESTO WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-9594
Mailing Address - Country:US
Mailing Address - Phone:661-302-2875
Mailing Address - Fax:
Practice Address - Street 1:2151 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-4113
Practice Address - Country:US
Practice Address - Phone:661-868-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95336337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse