Provider Demographics
NPI:1205402120
Name:GUERRERO, ELLA MARIE (HIS)
Entity type:Individual
Prefix:
First Name:ELLA MARIE
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 30TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3316
Mailing Address - Country:US
Mailing Address - Phone:510-832-4056
Mailing Address - Fax:510-929-4217
Practice Address - Street 1:400 30TH ST STE 101
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3316
Practice Address - Country:US
Practice Address - Phone:510-832-4056
Practice Address - Fax:510-929-4217
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9000237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist