Provider Demographics
NPI:1922133594
Name:GUERRERO, MARISSA DONA
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:DONA
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARISSA
Other - Middle Name:
Other - Last Name:DONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 S ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-6919
Mailing Address - Country:US
Mailing Address - Phone:916-584-7800
Mailing Address - Fax:
Practice Address - Street 1:401 S ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-6919
Practice Address - Country:US
Practice Address - Phone:916-584-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87905106H00000X
CA96653106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist