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General NPI Number Information
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NPI Number | 1265095574
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Entity Type | Individual
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Provider Name | SUSAN EVBUOMWAN GUERRERO MFT
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Gender | Female
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 18200 YORBA LINDA BLVD STE 106
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City | YORBA LINDA
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State | CA
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Zip | 92886-4006
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Country | US
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Telephone | 714-646-8034
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Fax |
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Provider Business Mailing Address
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Address Line | 385 S MANCHESTER AVE UNIT 1046
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City | ORANGE
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State | CA
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Zip | 92868-3238
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Country | US
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Telephone |
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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 | 141140
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License Number State | CA
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