Basic Information
| Provider Information | |||||||||
| NPI: | 1316307051 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORENO-GUERRERO | ||||||||
| FirstName: | FRANCISCO | ||||||||
| MiddleName: | RAFAEL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MFTI | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MORENO-GUERRERO | ||||||||
| OtherFirstName: | FRANCISCO | ||||||||
| OtherMiddleName: | RAFAEL | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 516 N KAWEAH AVE | ||||||||
| Address2: | |||||||||
| City: | EXETER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932211200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595944969 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 516 N KAWEAH AVE | ||||||||
| Address2: | |||||||||
| City: | EXETER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932211200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595944969 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 91860 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.