MEDICARE: MRS. KRISTINE MICHELLE GUERRA M.S., LMFT

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	106H00000X	Marriage & Family Therapist	LMFT50115	CA

General Provider Information

NPI Number	:	1912063108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTINE MICHELLE GUERRA M.S., LMFT

Provider Business Mailing Address
First Line	:	1099 E CHAMPLAIN DR STE A PMB 191
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-5030
Country	:	US
Telephone Number	:	559-779-2490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1363 E VIA CORSICA PL
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-8801
Country	:	US
Telephone Number	:	559-930-9982
Fax Number	:

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	04/07/2023

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