Provider Demographics
NPI:1184744724
Name:GUERRERO, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 HAWKINS LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-2205
Mailing Address - Country:US
Mailing Address - Phone:209-832-9213
Mailing Address - Fax:209-526-0908
Practice Address - Street 1:1660 W LINNE RD # J-23
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-8024
Practice Address - Country:US
Practice Address - Phone:209-640-1892
Practice Address - Fax:209-221-7029
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46476106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist