Healthcare Provider Details

I. General information

NPI: 1790518975
Provider Name (Legal Business Name): JOCELYN GUERRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MILAGROS ANDRADA LOO DOS

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13330 BLOOMFIELD AVE STE 201
NORWALK CA
90650-3262
US

IV. Provider business mailing address

131 S BARRANCA ST APT 276
WEST COVINA CA
91791-2264
US

V. Phone/Fax

Practice location:
  • Phone: 562-664-1715
  • Fax: 562-664-1708
Mailing address:
  • Phone: 562-664-1715
  • Fax: 562-664-1708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number26167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: