Provider Demographics
NPI:1356645386
Name:GUERRE-AGUILAR, BRITT-MARY (CPO)
Entity Type:Individual
Prefix:
First Name:BRITT-MARY
Middle Name:
Last Name:GUERRE-AGUILAR
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 BROOKSIDE AVE STE J5
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6303
Mailing Address - Country:US
Mailing Address - Phone:909-793-5226
Mailing Address - Fax:909-793-2787
Practice Address - Street 1:1150 BROOKSIDE AVE STE J5
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6303
Practice Address - Country:US
Practice Address - Phone:909-793-5226
Practice Address - Fax:909-793-2787
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO 1881222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist