Individual
JENNIFER O TY-DE GUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP,DNP,PMHNP
Contact information
Practice address
14023 PARAMOUNT BLVD, PARAMOUNT, CA 90723-2605
(562) 988-3370
(562) 988-3373
Mailing address
14023 PARAMOUNT BLVD, PARAMOUNT, CA 90723-2605
(562) 988-3370
(562) 988-3373
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
508898
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
12561
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA08212F
—
CA
Enumeration date
04/15/2020
Last updated
04/15/2020
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