MEDICARE: BIANCA EVETTE GUERRA ASW

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
1	1041C0700X	Clinical Social Worker	136479	CA

General Provider Information

NPI Number	:	1073467932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA EVETTE GUERRA ASW

Provider Business Mailing Address
First Line	:	7667 KELLEY DR APT 4
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-1154
Country	:	US
Telephone Number	:	209-650-9403
Fax Number	:

Provider Business Practice Location Address
First Line	:	1803 W MARCH LN STE C
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-6414
Country	:	US
Telephone Number	:	209-636-5355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	02/25/2026

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