Provider Demographics
NPI:1477016293
Name:GUERRA, JOSHUA NOEL
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:NOEL
Last Name:GUERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 SE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OR
Mailing Address - Zip Code:97391-1613
Mailing Address - Country:US
Mailing Address - Phone:541-336-2254
Mailing Address - Fax:
Practice Address - Street 1:321 SE 3RD ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OR
Practice Address - Zip Code:97391-1613
Practice Address - Country:US
Practice Address - Phone:541-336-2254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health