Provider Demographics
NPI:1194417170
Name:GUZMAN, NIKELLE R (DC)
Entity type:Individual
Prefix:DR
First Name:NIKELLE
Middle Name:R
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VENTURE STE 115
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7347
Mailing Address - Country:US
Mailing Address - Phone:949-594-3761
Mailing Address - Fax:
Practice Address - Street 1:6 VENTURE STE 115
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7347
Practice Address - Country:US
Practice Address - Phone:949-594-3761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor