Provider Demographics
NPI:1043504947
Name:MOORE-GUERRA, LISSETTE N/A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LISSETTE
Middle Name:N/A
Last Name:MOORE-GUERRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LISSETTE
Other - Middle Name:N/A
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:660 S FAIR OAKS
Mailing Address - Street 2:VHC AT SUNNYVALE
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:660 S FAIR OAKS
Practice Address - Street 2:VHC AT SUNNYVALE
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086
Practice Address - Country:US
Practice Address - Phone:408-885-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical