Provider Demographics
NPI:1780039339
Name:GUZMAN PICHARDO, SULEYMA GUADALUPE
Entity Type:Individual
Prefix:
First Name:SULEYMA
Middle Name:GUADALUPE
Last Name:GUZMAN PICHARDO
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 1:32525 CANYON VISTA RD APT A
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-9306
Mailing Address - Country:US
Mailing Address - Phone:760-969-9958
Mailing Address - Fax:
Practice Address - Street 1:32525 CANYON VISTA RD APT A
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-9306
Practice Address - Country:US
Practice Address - Phone:760-969-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program