Basic Information
| Provider Information | |||||||||
| NPI: | 1700219797 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUERRERO | ||||||||
| FirstName: | LILY | ||||||||
| MiddleName: | AMBER | ||||||||
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| Credential: | OTR/L, SPT, MOT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40680 CALIFORNIA OAKS RD | ||||||||
| Address2: | STE 2A | ||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925625755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009449782 | ||||||||
| FaxNumber: | 6104382046 | ||||||||
| Practice Location | |||||||||
| Address1: | 3140 EL CAMINO REAL | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920082108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607209898 | ||||||||
| FaxNumber: | 7607201636 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2013 | ||||||||
| LastUpdateDate: | 04/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT13264 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.