Basic Information
| Provider Information | |||||||||
| NPI: | 1790217594 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUERRERO | ||||||||
| FirstName: | KIANA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19270 SONOMA HWY | ||||||||
| Address2: | |||||||||
| City: | SONOMA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7079396070 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3883 AIRWAY DR STE 202 | ||||||||
| Address2: | |||||||||
| City: | SANTA ROSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954031671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7073033600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2017 | ||||||||
| LastUpdateDate: | 12/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A158485 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.