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1414 S Miller St Ste P Santa Maria CA 93454-6915 | |
| (805) 283-9522 | |
| (805) 738-7880 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1414 S Miller St Ste P, Santa Maria, California |
| Authorized Official Name and Position | Carlos R Guerrero (CEO) |
| Authorized Official Contact | 8052839522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1130 E Clark Ave Ste 150 # 378 Santa Maria CA 93455-3479 Ph: (805) 260-5619 | 1414 S Miller St Ste P Santa Maria CA 93454-6915 Ph: (805) 283-9522 |
| NPI Number | 1215689716 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 12/16/2024 |
| Certification Date | 12/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215689716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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