Active NPI
Andrea Felice Guzman, MFT
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1720100316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 45958
- Practice address
- 2351 Cardinal LN
San Diego, CA 92123-3743 - Phone
- (619) 829-3050
- NPI assigned
- Apr 4, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preferred Provider Organization | 305R00000X | 45958 | CA | |
| Marriage & Family Therapist | 106H00000X | 45958 | CA | Primary |
Addresses
Primary practice location
2351 Cardinal LN
San Diego, CA 92123-3743
Mailing address
269 Aventura Dr
8
Chula Vista, CA 91914-4470
Phone (310) 612-2811
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00007570 | Medicaid | CA | |
| SUBB036 | Other | CA | LA DMH PROVIDER |
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 |
|---|---|---|---|
| 45958 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305763200000",
"number": "1720100316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269 AVENTURA DR",
"address_2": "8",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919144470",
"telephone_number": "310-612-2811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2351 CARDINAL LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921233743",
"telephone_number": "619-829-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUZMAN",
"first_name": "ANDREA",
"middle_name": "FELICE",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2011-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "305R00000X",
"taxonomy_group": "",
"desc": "Preferred Provider Organization",
"state": "CA",
"license": "45958",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "45958",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00007570",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA DMH PROVIDER",
"identifier": "SUBB036",
"state": "CA"
}
],
"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 May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.