Jennifer O Ty-de Guzman, MSN, FNP,DNP,PMHNP

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

508898 Issued in CA

Practice address

14023 Paramount Blvd
Paramount, CA 90723-2605

Phone

(562) 988-3370

Fax

(562) 988-3373

NPI assigned

Apr 15, 2020

Last updated

Apr 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Excell Home Care, Inc.

  • Home Health Agency
  • Long Beach, CA
  • NPI 1588630081

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Practicare Home Health Agency

  • Home Health Agency
  • Arcadia, CA
  • NPI 1639167208

  5% Or Greater Direct Ownership Interest, Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Excell Integrated Medical Group Inc

  • Family Medicine Physician
  • Paramount, CA
  • NPI 1659909521
  Medicare reassignment NPD
• Excell Home Care, Inc.

  • Home Health Agency
  • Long Beach, CA
  • NPI 1588630081
  Authorized official Same address or phone

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1790304194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14023 PARAMOUNT BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907232605",
            "telephone_number": "562-988-3370",
            "fax_number": "562-988-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14023 PARAMOUNT BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907232605",
            "telephone_number": "562-988-3370",
            "fax_number": "562-988-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TY-DE GUZMAN",
        "first_name": "JENNIFER",
        "middle_name": "O",
        "credential": "MSN, FNP,DNP,PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "12561",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "508898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08212F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Paramount",
            "affiliation": "N",
            "address_1": "14023 Paramount Blvd",
            "city": "Paramount",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907232605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sergio Ibanez Trani Jr., M.D.
• Sulochana Trivedi, M.D.
• Mark Chung-Hsun Tsai, M.D.
• Robert Shou Jen Tsai, MD
• Nina A Turner
• Chinedu John Ugorji, M.D.
• United Speech Specialists Inc.
• Olivier Urayeneza, M.D.
• Laritha Vaughn, CAS II, MA, MFTI
• Karla Desire Vazquez, RN

• Home Health Registered Nurse in Paramount, CA
• Providers in Paramount, CA by specialty
• Home Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.