Provider Demographics
NPI:1548966377
Name:GUEVARA, YESENIA NOAMI
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:NOAMI
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:PIERCE
Mailing Address - State:CO
Mailing Address - Zip Code:80650-0026
Mailing Address - Country:US
Mailing Address - Phone:970-324-9526
Mailing Address - Fax:
Practice Address - Street 1:830 1ST ST # 24
Practice Address - Street 2:
Practice Address - City:PIERCE
Practice Address - State:CO
Practice Address - Zip Code:80650-5017
Practice Address - Country:US
Practice Address - Phone:970-324-9526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health