Provider Demographics
NPI:1396349973
Name:GUERRA, NATASHA VEDA GABRIELLA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:VEDA GABRIELLA
Last Name:GUERRA
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 1:1563 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2543
Mailing Address - Country:US
Mailing Address - Phone:415-762-3700
Mailing Address - Fax:415-865-0119
Practice Address - Street 1:890 HAYES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2615
Practice Address - Country:US
Practice Address - Phone:415-762-3700
Practice Address - Fax:415-865-0118
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13960-RAC101YA0400X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)