Healthcare Provider Details

I. General information

NPI: 1528654464
Provider Name (Legal Business Name): JESUS GUERRA BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 FERRY ST
MARTINEZ CA
94553-1125
US

IV. Provider business mailing address

3234 ALHAMBRA AVE
MARTINEZ CA
94553-3110
US

V. Phone/Fax

Practice location:
  • Phone: 510-224-1025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: