Provider Demographics
NPI:1508210162
Name:GUILLEN-BARRIENTOS, ALFREDO DENNIS
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:DENNIS
Last Name:GUILLEN-BARRIENTOS
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 1:912 S BENSON AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-4703
Mailing Address - Country:US
Mailing Address - Phone:323-835-2087
Mailing Address - Fax:
Practice Address - Street 1:912 S BENSON AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-4703
Practice Address - Country:US
Practice Address - Phone:323-835-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist