Basic Information
Provider Information
NPI: 1467701771
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUERTA GUZMAN
FirstName: HELEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 919
Address2:  
City: FULLERTON
State: CA
PostalCode: 92836
CountryCode: US
TelephoneNumber: 7146809000
FaxNumber:  
Practice Location
Address1: 120 S STATE COLLEGE BLVD STE 150
Address2:  
City: BREA
State: CA
PostalCode: 928215837
CountryCode: US
TelephoneNumber: 7145775400
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2012
LastUpdateDate: 10/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X111432CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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