Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 14661 | CA |
NPI | 1851795264 |
---|---|
Provider Name | Jovita Guzman |
First Address | Vallejo, CA 94589-2441 |
Second Address | Vallejo, CA 94589-2441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2014 |
Last Update Date | 03/01/2022 |