Individual provider Active NPI

Marivic Guzman, BSN RN, VA-BC

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1649757337
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
662208 Issued in CA
Practice address
10981 San Diego Mission Rd Ste 112
San Diego, CA 92108-2448
Phone
(619) 693-7399
NPI assigned
Jul 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 662208 CA
Registered Nurse 163W00000X 662208 CA Primary

Addresses

Primary practice location

10981 San Diego Mission Rd Ste 112
San Diego, CA 92108-2448

Mailing address

10981 San Diego Mission Rd Ste 112
San Diego, CA 92108-2448
Phone (619) 693-7399

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)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
662208CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Picc Nurse LLC Registered Nurse CurrentSince Aug 15, 2017 Accepting new patients

Locations

10981 San Diego Mission Rd
Ste 112
San Diego, CA 92108
Phone (619) 693-7399

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": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1649757337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10981 SAN DIEGO MISSION RD STE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082448",
            "telephone_number": "619-693-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10981 SAN DIEGO MISSION RD STE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082448",
            "telephone_number": "619-693-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "MARIVIC",
        "name_prefix": "Mrs.",
        "credential": "BSN RN, VA-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "662208",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "662208",
            "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 Sep 4, 2019; 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.