Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | CA |
NPI | 1073133427 |
---|---|
Provider Name | Abigail Guzman |
First Address | San Diego, CA 92114-5848 |
Second Address | Chula Vista, CA 91914-3622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2020 |
Last Update Date | 24/04/2020 |