Provider Demographics
NPI:1619696473
Name:GUEVARA, ADRIANA MERAIH
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:MERAIH
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15087 CHRISTOPHER ST
Mailing Address - Street 2:
Mailing Address - City:ADELANTO
Mailing Address - State:CA
Mailing Address - Zip Code:92301-6147
Mailing Address - Country:US
Mailing Address - Phone:818-292-4567
Mailing Address - Fax:
Practice Address - Street 1:15087 CHRISTOPHER ST
Practice Address - Street 2:
Practice Address - City:ADELANTO
Practice Address - State:CA
Practice Address - Zip Code:92301-6147
Practice Address - Country:US
Practice Address - Phone:818-292-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician