Provider Demographics
NPI:1730919846
Name:GUZMAN, PRISCILLA (RN)
Entity type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 VERONICA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-1134
Mailing Address - Country:US
Mailing Address - Phone:714-488-2237
Mailing Address - Fax:
Practice Address - Street 1:1717 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-3319
Practice Address - Country:US
Practice Address - Phone:310-450-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA769490163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool