Provider Demographics
NPI:1063172286
Name:GUZMAN-CRESPO, MONICA PAOLA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:PAOLA
Last Name:GUZMAN-CRESPO
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4511
Mailing Address - Country:US
Mailing Address - Phone:833-867-4642
Mailing Address - Fax:360-462-2743
Practice Address - Street 1:1030 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4511
Practice Address - Country:US
Practice Address - Phone:833-867-4642
Practice Address - Fax:360-462-2743
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA60514363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant