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NPI Code Detail

MEDICARE: VIVIAN GUERRA

MEDICARE:   VIVIAN  GUERRA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1043155518
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN GUERRA
Provider Business Mailing Address
First Line : 6770 PATS RANCH RD UNIT 9210
Second Line :
City : JURUPA VALLEY
State : CA
Zip : 91752-4841
Country : US
Telephone Number : 951-254-5730
Fax Number :
Provider Business Practice Location Address
First Line : 6770 PATS RANCH RD UNIT 9210
Second Line :
City : JURUPA VALLEY
State : CA
Zip : 91752-4841
Country : US
Telephone Number : 951-254-5730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/29/2026

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Directions to “ VIVIAN GUERRA ” Practice Location

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