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NPI Code Detail

MEDICARE: JAZMIN GUERRA LOPEZ

MEDICARE: JAZMIN GUERRA LOPEZ
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
1175T00000XPeer SpecialistCA

General Provider Information

NPI Number : 1780474114
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAZMIN GUERRA LOPEZ
Provider Business Mailing Address
First Line : PO BOX 15408
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93406-5408
Country : US
Telephone Number : 805-540-6500
Fax Number :
Provider Business Practice Location Address
First Line : 784 HIGH ST
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-5243
Country : US
Telephone Number : 805-540-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2025
Last Update Date : 03/23/2026

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Directions to “ JAZMIN GUERRA LOPEZ ” Practice Location

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