Provider Demographics
NPI:1891564472
Name:MERAS, GUILLERMO SUNNY
Entity Type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:SUNNY
Last Name:MERAS
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 1:5242 VESPER AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-4094
Mailing Address - Country:US
Mailing Address - Phone:818-383-9592
Mailing Address - Fax:
Practice Address - Street 1:5416 E OLETA ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4428
Practice Address - Country:US
Practice Address - Phone:714-270-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABACB583095106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician