Provider Demographics
NPI:1811143373
Name:GUERRERO-TELLEZ, ROSA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:GUERRERO-TELLEZ
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 1:630 RIVIERA CT
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-1291
Mailing Address - Country:US
Mailing Address - Phone:805-443-6706
Mailing Address - Fax:
Practice Address - Street 1:1305 DEL NORTE RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8436
Practice Address - Country:US
Practice Address - Phone:805-485-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist