Individual provider Active NPI

Kelly Cassandra Guzman

  • Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1548874407
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1102 Bluestone River Way
Bakersfield, CA 93311-9259
Phone
(609) 251-0949
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

1102 Bluestone River Way
Bakersfield, CA 93311-9259

Mailing address

1102 Bluestone River Way
Bakersfield, CA 93311-9259
Phone (609) 251-0949

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201029002494 CA Practitioner - Physician Assistant 4486064649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58522CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Urgent Care Inc. Single Specialty CurrentSince Nov 1, 2020 Accepting new patients

Locations

9710 Brimhall Rd
Bakersfield, CA 93312
Phone (661) 331-8640

212 Coffee Rd
Ste 100
Bakersfield, CA 93309
Phone (661) 885-6060

6789 N Blackstone Ave
Fresno, CA 93710
Phone (559) 512-3377

41540 Winchester Rd
Temecula, CA 92590
Phone (951) 365-5585

Organizations & group practices 1

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1548874407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 BLUESTONE RIVER WAY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119259",
            "telephone_number": "609-251-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 BLUESTONE RIVER WAY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119259",
            "telephone_number": "609-251-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "KELLY",
        "middle_name": "CASSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.