Provider Demographics
NPI:1871323634
Name:GUZMAN, MAHRYA VICTORIA CELINE (BACHELORS, MASTERS)
Entity type:Individual
Prefix:
First Name:MAHRYA
Middle Name:VICTORIA CELINE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:BACHELORS, MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5280 LITTLE MOUNTAIN DR APT K1
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-4932
Mailing Address - Country:US
Mailing Address - Phone:951-388-7728
Mailing Address - Fax:
Practice Address - Street 1:2133 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92377-4407
Practice Address - Country:US
Practice Address - Phone:909-873-1817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator