Provider Demographics
NPI:1801044524
Name:GUZMAN, REGINA (LCSW)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1563
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-8563
Mailing Address - Country:US
Mailing Address - Phone:626-507-3778
Mailing Address - Fax:
Practice Address - Street 1:6601 STEPHENS RANCH RD
Practice Address - Street 2:
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750-1146
Practice Address - Country:US
Practice Address - Phone:213-334-8929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical