Provider Demographics
NPI:1255429858
Name:GUERRERO, MARTHA ALICE (LCSW)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:ALICE
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ALICE GUERRERO
Other - Last Name:FLAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1100 K ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-3931
Mailing Address - Country:US
Mailing Address - Phone:916-441-7888
Mailing Address - Fax:
Practice Address - Street 1:1100 K ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-3931
Practice Address - Country:US
Practice Address - Phone:916-441-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical