Individual
VINCENT DE GUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6757 BLUEFIELD CT, CORONA, CA 92880-3795
(626) 201-2754
Mailing address
6757 BLUEFIELD CT, CORONA, CA 92880-3795
(626) 201-2754
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
34698
CA
Other
Enumeration date
03/20/2009
Last updated
05/08/2009
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