Provider Demographics
NPI:1336995281
Name:GUERRERO, JENNIFER KATRINA (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KATRINA
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 QUAIL RUN CIR
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-7058
Mailing Address - Country:US
Mailing Address - Phone:209-627-6762
Mailing Address - Fax:
Practice Address - Street 1:363 QUAIL RUN CIR
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-7058
Practice Address - Country:US
Practice Address - Phone:209-627-6762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95369799163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse