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General NPI Number Information
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NPI Number | 1225250046
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Entity Type | Individual
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Provider Name | GINA LEE GUERRERO M.A
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 04/12/2009
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Provider Practice Location Address
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Address Line | 14795 JEFFREY ROAD, SUITE 204
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City | IRVINE
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State | CA
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Zip | 92618-0416
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Country | US
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Telephone | 949-350-0891
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Fax | 949-559-4590
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Provider Business Mailing Address
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Address Line | 33 VIA VICINI
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688
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Country | US
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Telephone | 949-766-8376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC#47046
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License Number State | CA
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