Provider Demographics
NPI:1497371835
Name:GUIMOND, SAVANNAH WHITNEY (LCSW)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:WHITNEY
Last Name:GUIMOND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 JUNIPER ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-5435
Mailing Address - Country:US
Mailing Address - Phone:619-268-1330
Mailing Address - Fax:
Practice Address - Street 1:2932 JUNIPER ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-5435
Practice Address - Country:US
Practice Address - Phone:619-268-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96717101YM0800X, 1041C0700X
171M00000X
CA1177371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator