Provider Demographics
NPI:1366004582
Name:GUERRERO-PROCTOR, TRACY LEE (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LEE
Last Name:GUERRERO-PROCTOR
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:DR
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:PROCTOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LMFT
Mailing Address - Street 1:PO BOX 6659
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-6659
Mailing Address - Country:US
Mailing Address - Phone:949-525-2498
Mailing Address - Fax:
Practice Address - Street 1:2894 MELLOR ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3585
Practice Address - Country:US
Practice Address - Phone:949-525-2498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist