Healthcare Provider Details

I. General information

NPI: 1578227161
Provider Name (Legal Business Name): JOSE GUERRA, PSYCHOLOGIST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9010 CORBIN AVE STE 4
NORTHRIDGE CA
91324-3392
US

IV. Provider business mailing address

PO BOX 8011
LA CRESCENTA CA
91224-0011
US

V. Phone/Fax

Practice location:
  • Phone: 818-770-6147
  • Fax: 213-232-1008
Mailing address:
  • Phone: 818-770-6147
  • Fax: 213-232-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE GUERRA
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 818-770-6147