Basic Information
| Provider Information | |||||||||
| NPI: | 1003140476 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUERRERO | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | GARCIA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LCSW | ||||||||
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| 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: | 07/01/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | LCSW89025 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.