Healthcare Provider Details

I. General information

NPI: 1154801280
Provider Name (Legal Business Name): JOHN FRANCISCO GUERRERO FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 10/15/2023
Certification Date: 10/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 W MAIN ST STE B
EL CENTRO CA
92243-5420
US

IV. Provider business mailing address

23516 BELL BLUFF TRUCK TRL
ALPINE CA
91901-3301
US

V. Phone/Fax

Practice location:
  • Phone: 760-592-7760
  • Fax: 760-592-7765
Mailing address:
  • Phone: 760-975-5305
  • Fax: 760-592-7765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberTRN216638
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95011556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: