Provider Demographics
NPI:1710283353
Name:GUERRERO, EFRAIN A (RNNP)
Entity Type:Individual
Prefix:MR
First Name:EFRAIN
Middle Name:A
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 S IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4241
Mailing Address - Country:US
Mailing Address - Phone:760-337-1025
Mailing Address - Fax:760-336-0803
Practice Address - Street 1:529 PINE AVE
Practice Address - Street 2:
Practice Address - City:HOLTVILLE
Practice Address - State:CA
Practice Address - Zip Code:92250-1121
Practice Address - Country:US
Practice Address - Phone:760-356-5568
Practice Address - Fax:760-356-5566
Is Sole Proprietor?:No
Enumeration Date:2011-01-30
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN246188163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse