Basic Information
| Provider Information | |||||||||
| NPI: | 1568863967 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARELLANO GUZMAN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6455 BLUE JAY DR | ||||||||
| Address2: | |||||||||
| City: | BUENA PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906201320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9496805531 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 801 E CHAPMAN AVE STE 203 | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928313846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146808268 | ||||||||
| FaxNumber: | 7146808233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2014 | ||||||||
| LastUpdateDate: | 06/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 72615 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | 108103 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.