Provider Demographics
NPI:1154801280
Name:GUERRERO, JOHN FRANCISCO (FNP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCISCO
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23516 BELL BLUFF TRUCK TRL
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-3301
Mailing Address - Country:US
Mailing Address - Phone:760-975-5305
Mailing Address - Fax:760-592-7765
Practice Address - Street 1:1671 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-5420
Practice Address - Country:US
Practice Address - Phone:760-592-7760
Practice Address - Fax:760-592-7765
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTRN216638163WE0003X
CA95011556363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WE0003XNursing Service ProvidersRegistered NurseEmergencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95011556OtherCALIFORNIA BRN
AZJFGUERRERO27OtherCMS