Healthcare Provider Details

I. General information

NPI: 1003753245
Provider Name (Legal Business Name): MELISSA MARIE GUERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58471 TWENTY-NINE PALMS HWY SUITE 102
YUCCA VALLEY CA
92284
US

IV. Provider business mailing address

58471 TWENTY-NINE PALMS HWY SUITE 102
YUCCA VALLEY CA
92284
US

V. Phone/Fax

Practice location:
  • Phone: 760-853-4755
  • Fax: 760-418-2201
Mailing address:
  • Phone: 760-853-4755
  • Fax: 760-418-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: