Active NPI
Nicole S Guzman
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1548419781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 24952
- Practice address
- 2247 San Diego Ave
136
San Diego, CA 92110-2068 - Phone
- (858) 205-9809
- NPI assigned
- Sep 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 24952 | CA | Primary |
Addresses
Primary practice location
2247 San Diego Ave
136
San Diego, CA 92110-2068
Mailing address
3474 Governor Dr
San Diego, CA 92122-2903
Phone (818) 919-3428
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24952 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1548419781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3474 GOVERNOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921222903",
"telephone_number": "818-919-3428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2247 SAN DIEGO AVE",
"address_2": "136",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921102068",
"telephone_number": "858-205-9809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUZMAN",
"first_name": "NICOLE",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-11",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "24952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.