Provider Demographics
NPI:1982789186
Name:GUESS, KENNETH SCOTT (PHARMD, MS PHAM,)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:SCOTT
Last Name:GUESS
Suffix:
Gender:M
Credentials:PHARMD, MS PHAM,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 CORAL DR
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-3433
Mailing Address - Country:US
Mailing Address - Phone:805-704-1934
Mailing Address - Fax:805-256-1475
Practice Address - Street 1:1673 CORAL DR
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-3433
Practice Address - Country:US
Practice Address - Phone:805-714-3908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37953183500000X, 183500000X
CA100421835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37953OtherPHARMACIST LICENSE
CAAPH 10042OtherADVANCED PRACTICE PHARAMACIST