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NPI Code Detail

MEDICARE: JESSICA D GUERRA

MEDICARE:   JESSICA D GUERRA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1174024707
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA D GUERRA
Provider Business Mailing Address
First Line : 2524 E SCOTTS AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95205-7136
Country : US
Telephone Number : 209-696-0146
Fax Number :
Provider Business Practice Location Address
First Line : 2291 W MARCH LN STE C101
Second Line :
City : STOCKTON
State : CA
Zip : 95207-6669
Country : US
Telephone Number : 916-729-3098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2018
Last Update Date : 02/28/2018

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Directions to “ JESSICA D GUERRA ” Practice Location

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