Provider Demographics
NPI:1710082839
Name:GUZMAN TORRES, SANDRA (MFT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:GUZMAN TORRES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:3228 RIVERSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-4050
Mailing Address - Country:US
Mailing Address - Phone:916-678-8347
Mailing Address - Fax:916-565-0464
Practice Address - Street 1:3228 RIVERSIDE BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-4050
Practice Address - Country:US
Practice Address - Phone:916-678-8347
Practice Address - Fax:916-565-0464
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA480454OtherMHN