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NPI Code Detail

MEDICARE: BREANNA GUERRERO

MEDICARE: BREANNA GUERRERO
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 : 1336622919
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA GUERRERO
Provider Business Mailing Address
First Line : 4146 UNIVERSITY AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-3140
Country : US
Telephone Number : 626-353-8933
Fax Number : 626-602-3875
Provider Business Practice Location Address
First Line : 4146 UNIVERSITY AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92501-3140
Country : US
Telephone Number : 626-353-8933
Fax Number : 626-602-3875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 09/10/2018

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Directions to “ BREANNA GUERRERO ” Practice Location

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