Provider Demographics
NPI:1518516806
Name:GUDINO, AMBAR XHANTE (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMBAR
Middle Name:XHANTE
Last Name:GUDINO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10073 VALLEY VIEW ST # 247
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-4601
Mailing Address - Country:US
Mailing Address - Phone:562-967-4977
Mailing Address - Fax:
Practice Address - Street 1:10073 VALLEY VIEW ST # 247
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-4601
Practice Address - Country:US
Practice Address - Phone:562-967-4977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health