Provider Demographics
NPI:1861807851
Name:GUERRERO, ERNESTO II
Entity type:Individual
Prefix:
First Name:ERNESTO
Middle Name:
Last Name:GUERRERO
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38392 WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5089
Mailing Address - Country:US
Mailing Address - Phone:805-816-0568
Mailing Address - Fax:
Practice Address - Street 1:30755 AULD RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2599
Practice Address - Country:US
Practice Address - Phone:951-600-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD8040680104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker