Provider Demographics
NPI:1275332298
Name:GUERRERO, LISA MARIE (CMT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:GUERRERO
Suffix:
Gender:
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17010 MARYGOLD AVE APT 17
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6768
Mailing Address - Country:US
Mailing Address - Phone:909-787-4877
Mailing Address - Fax:
Practice Address - Street 1:14252 SCHLEISMAN RD STE 202
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-4026
Practice Address - Country:US
Practice Address - Phone:951-268-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist