Provider Demographics
NPI:1902418205
Name:GUZMAN, JOHN PAUL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 OAK PARK BLVD APT 33
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4485
Mailing Address - Country:US
Mailing Address - Phone:916-862-2295
Mailing Address - Fax:
Practice Address - Street 1:4341 PIEDMONT AVE STE 201
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4792
Practice Address - Country:US
Practice Address - Phone:510-547-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist