Provider Demographics
NPI:1861805533
Name:GUZMAN ZAVALA, LUIS ROBERTO
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ROBERTO
Last Name:GUZMAN ZAVALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 ROSECRANS AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-2246
Mailing Address - Country:US
Mailing Address - Phone:562-807-6200
Mailing Address - Fax:562-461-4388
Practice Address - Street 1:9400 ROSECRANS AVE FL 4
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2246
Practice Address - Country:US
Practice Address - Phone:562-807-6200
Practice Address - Fax:562-461-4388
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT1343351106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist