Healthcare Provider Details

I. General information

NPI: 1518429232
Provider Name (Legal Business Name): YOLANDA ALICIA GUERRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 MISSION GORGE RD STE O
SANTEE CA
92071-3040
US

IV. Provider business mailing address

1400 N JOHNSON AVE STE 101
EL CAJON CA
92020-1651
US

V. Phone/Fax

Practice location:
  • Phone: 619-383-6868
  • Fax:
Mailing address:
  • Phone: 619-401-4801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: