Provider Demographics
NPI:1275257511
Name:GUERRERO, MARIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIN
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARIN
Other - Middle Name:
Other - Last Name:BURGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 CABLE CIR APT 14
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6908
Mailing Address - Country:US
Mailing Address - Phone:916-752-1510
Mailing Address - Fax:
Practice Address - Street 1:4987 GOLDEN FOOTHILL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9364
Practice Address - Country:US
Practice Address - Phone:916-365-2411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20991225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist