Basic Information
Provider Information
NPI: 1003140476
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUERRERO
FirstName: LINDA
MiddleName: GARCIA
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3530 ATLANTIC AVE STE 210
Address2:  
City: LONG BEACH
State: CA
PostalCode: 908074569
CountryCode: US
TelephoneNumber: 5624241886
FaxNumber: 5624242296
Practice Location
Address1: 3530 ATLANTIC AVE STE 210
Address2:  
City: LONG BEACH
State: CA
PostalCode: 908074569
CountryCode: US
TelephoneNumber: 5624241886
FaxNumber: 5624242296
Other Information
ProviderEnumerationDate: 10/01/2009
LastUpdateDate: 09/27/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home