Provider Demographics
NPI:1821254509
Name:GUERRERO, GINA ALEYANDRA (MA, MFT INTERN)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:ALEYANDRA
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MA, MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23502 LYONS AVE
Mailing Address - Street 2:STE. 304
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2535
Mailing Address - Country:US
Mailing Address - Phone:661-286-2562
Mailing Address - Fax:661-222-7709
Practice Address - Street 1:23502 LYONS AVE
Practice Address - Street 2:STE. 304
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2535
Practice Address - Country:US
Practice Address - Phone:661-286-2562
Practice Address - Fax:661-222-7709
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC53510106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist