Provider Demographics
NPI:1881617058
Name:GUY, GEORGINA (PSYD)
Entity type:Individual
Prefix:DR
First Name:GEORGINA
Middle Name:
Last Name:GUY
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:PO BOX 4827
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92690-4827
Mailing Address - Country:US
Mailing Address - Phone:949-378-3058
Mailing Address - Fax:949-215-2486
Practice Address - Street 1:26461 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6377
Practice Address - Country:US
Practice Address - Phone:949-378-3058
Practice Address - Fax:949-215-2486
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist