MEDICARE: GUILLERMA TAMARRA ALFARERO L.V.N.

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	164X00000X	Licensed Vocational Nurse	169414	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184777237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMA TAMARRA ALFARERO L.V.N.

Provider Business Mailing Address
First Line	:	6281 N MALSBURY AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-0957
Country	:	US
Telephone Number	:	559-435-5732
Fax Number	:

Provider Business Practice Location Address
First Line	:	5070 E BELGRAVIA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93725-1239
Country	:	US
Telephone Number	:	559-255-3486
Fax Number	:

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

Provider Enumeration Date	:	01/20/2007
Last Update Date	:	07/08/2007

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