Individual provider Active NPI

Marisela Guzman Chavez, MSW

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1174804603
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW79542 Issued in CA
Practice address
1910 Magnolia Ave
Los Angeles, CA 90007-1220
Phone
(818) 355-8504
Fax
(855) 929-5512
NPI assigned
Aug 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X ASW79542 CA Primary

Addresses

Primary practice location

1910 Magnolia Ave
Los Angeles, CA 90007-1220

Mailing address

1910 Magnolia Ave
Los Angeles, CA 90007-1220
Phone (818) 355-8504

Other practice location 1

2640 E Garvey Ave S
West Covina, CA 91791-2156
Phone (818) 355-8504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW79542CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1174804603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 MAGNOLIA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900071220",
            "telephone_number": "818-355-8504",
            "fax_number": "855-929-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 MAGNOLIA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900071220",
            "telephone_number": "818-355-8504",
            "fax_number": "855-929-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2640 E Garvey Ave S",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917912156",
            "country_code": "US",
            "telephone_number": "818-355-8504",
            "fax_number": "855-929-5512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN CHAVEZ",
        "first_name": "MARISELA",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW79542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.