MEDICARE: MARTHA NEREIDA 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
1	235Z00000X	Speech-Language Pathologist	40970	CA

General Provider Information

NPI Number	:	1912511742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA NEREIDA GUERRERO

Provider Business Mailing Address
First Line	:	255 E RINCON ST STE 321
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-1368
Country	:	US
Telephone Number	:	951-258-0547
Fax Number	:	951-574-0265

Provider Business Practice Location Address
First Line	:	255 E RINCON ST STE 321
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-1368
Country	:	US
Telephone Number	:	951-258-0547
Fax Number	:	951-574-0265

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

Provider Enumeration Date	:	08/31/2020
Last Update Date	:	02/20/2026

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