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Individual
WILFREDO V DEGUZMAN
Active
Individual
WILFREDO V DEGUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27BW8
MEDI-CAL
CA
01
—
41BW
MEDI-CAL
CA
01
—
A2510233
DRIVER'S LICENSE
CA
01
—
BWASOCFSP
MEDI-CAL
CA
01
—
PRVNBR
MEDI-CAL
CA
Enumeration date
08/21/2013
Last updated
08/21/2013
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