Provider Demographics
NPI:1275085672
Name:LEON GUERRERO, ANNA MARIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNA MARIA
Middle Name:
Last Name:LEON GUERRERO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 SYRACUSE CIR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4683
Mailing Address - Country:US
Mailing Address - Phone:707-631-6797
Mailing Address - Fax:
Practice Address - Street 1:1085 SYRACUSE CIR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4683
Practice Address - Country:US
Practice Address - Phone:707-631-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist