Individual provider Active NPI

Stephany Clara Guzman

  • Marriage & Family Therapist
  • Fountain Valley, CA
National Provider Identifier
1144852534
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT114332 Issued in CA
Practice address
18350 Mount Langley St Ste 200
Fountain Valley, CA 92708-6912
Phone
(949) 855-1556
NPI assigned
Feb 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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 AMFT114332 CA Primary

Addresses

Primary practice location

18350 Mount Langley St Ste 200
Fountain Valley, CA 92708-6912

Mailing address

18350 Mount Langley St Ste 200
Fountain Valley, CA 92708-6912
Phone (949) 855-1556

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
I20241119003761 CA Practitioner - Marriage and Family Therapist 2961937560 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AMFT114332CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Youth Services CurrentSince Mar 1, 2020 Accepting new patients
Wise Mind Counseling Services Inc. Marriage & Family Therapist CurrentSince Nov 6, 2024 Accepting new patients

Locations

18350 Mount Langley St
Ste 200
Fountain Valley, CA 92708
Phone (714) 450-4118

11801 Pierce St
Ste 200
Riverside, CA 92505
Phone (323) 547-2662

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1144852534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 MOUNT LANGLEY ST STE 200",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086912",
            "telephone_number": "949-855-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 MOUNT LANGLEY ST STE 200",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086912",
            "telephone_number": "949-855-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "STEPHANY",
        "middle_name": "CLARA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT114332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.