Provider Demographics
NPI:1073759247
Name:GUERRA, SONIA (BS)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:GUERRA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 E MAGNOLIA WAY
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-2228
Mailing Address - Country:US
Mailing Address - Phone:559-591-6680
Mailing Address - Fax:559-591-6684
Practice Address - Street 1:1617 E SAGINAW WAY
Practice Address - Street 2:SUITE # 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-4458
Practice Address - Country:US
Practice Address - Phone:559-274-0299
Practice Address - Fax:559-244-0328
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health