Provider Demographics
NPI:1578308409
Name:GUZMAN, KATIA YULISSA (OD)
Entity type:Individual
Prefix:DR
First Name:KATIA
Middle Name:YULISSA
Last Name:GUZMAN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15210 POLLOCK DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-4908
Mailing Address - Country:US
Mailing Address - Phone:832-752-2703
Mailing Address - Fax:
Practice Address - Street 1:341 W TUDOR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6639
Practice Address - Country:US
Practice Address - Phone:907-770-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK232700152W00000X
TX11233TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist