Provider Demographics
NPI:1366752016
Name:DEGUZMAN, EMILY PICAR (LVN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:PICAR
Last Name:DEGUZMAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:IDICA
Other - Last Name:PICAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:9903 MARBY GRANGE WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-5610
Mailing Address - Country:US
Mailing Address - Phone:661-343-9511
Mailing Address - Fax:
Practice Address - Street 1:1800 MT. VERNON AVENUE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3302
Practice Address - Country:US
Practice Address - Phone:661-868-0306
Practice Address - Fax:661-868-0560
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA186802164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse