Provider Demographics
NPI:1356742308
Name:GUERRERO, JESSICA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 W. COMPTON BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220
Mailing Address - Country:US
Mailing Address - Phone:279-782-3617
Mailing Address - Fax:
Practice Address - Street 1:322 W. COMPTON BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220
Practice Address - Country:US
Practice Address - Phone:279-782-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW99833104100000X
CAASW72053101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker