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Provider Information for 1104034420


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Ms. MINERVA GUZMAN LMFT


Sex: Female

NPI: 1104034420
Last Updated: 2024-11-21
Certification Date: 2024-11-21

Details

NameValue
NPI1104034420
Enumeration Date2007-05-18
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 725 N SUNSET AVE APT A6
WEST COVINA, CA 91790-1253
United States

Phone: 323-430-7776 | Fax:
 
Primary Practice Address 840 N AVENUE 66
LOS ANGELES, CA 90042-1508
United States

Phone: 626-395-7100 | Fax:
 
Secondary Practice Address(es)

725 N SUNSET AVE APT A6
WEST COVINA, CA 91790-1253
United States

Phone: 323-430-7776 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)CA952633765Medi-cal
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist CA111901