Basic Information
| Provider Information | |||||||||
| NPI: | 1093356560 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUERIN | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | INEZ | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4083 19TH AVE | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941323009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155198996 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 SNEATH LN STE 201 | ||||||||
| Address2: | |||||||||
| City: | SAN BRUNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940662349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6502141444 | ||||||||
| FaxNumber: | 6502441447 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2019 | ||||||||
| LastUpdateDate: | 10/04/2019 | ||||||||
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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 | 101YA0400X | 101YA0400X | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.