Provider Demographics
NPI:1013606045
Name:GUERRERO TORRES, BRIAN RAFAEL
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:RAFAEL
Last Name:GUERRERO TORRES
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 1:840 SEVELY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1607
Mailing Address - Country:US
Mailing Address - Phone:650-457-7055
Mailing Address - Fax:
Practice Address - Street 1:840 SEVELY DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-1607
Practice Address - Country:US
Practice Address - Phone:650-457-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician