Individual provider Active NPI

Minerva Guzman, LMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1104034420
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
111901 Issued in CA
Practice address
840 N Avenue 66
Los Angeles, CA 90042-1508
Phone
(626) 395-7100
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 111901 CA Primary

Addresses

Primary practice location

840 N Avenue 66
Los Angeles, CA 90042-1508

Mailing address

725 N Sunset Ave Apt A6
West Covina, CA 91790-1253
Phone (323) 430-7776

Other practice location 1

725 N Sunset Ave Apt A6
West Covina, CA 91790-1253
Phone (323) 430-7776

Other identifiers 1

IdentifierTypeStateIssuer
952633765OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125004034 CA Practitioner - Marriage and Family Therapist 5799210902 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Telehealth Specialty Medical Group CurrentSince Sep 19, 2024 Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients

Locations

9471 Haven Ave
Ste 140
Rch Cucamonga, CA 91730
Phone (909) 474-2333

3400 Douglas Blvd
Ste 170
Roseville, CA 95661
Phone (855) 446-8628

3400 Douglas Blvd
Ste 225
Roseville, CA 95661
Phone (916) 740-3721

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1104034420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N SUNSET AVE APT A6",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917901253",
            "telephone_number": "323-430-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N AVENUE 66",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421508",
            "telephone_number": "626-395-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N Sunset Ave Apt A6",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917901253",
            "country_code": "US",
            "telephone_number": "323-430-7776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "MINERVA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "952633765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.