Basic Information
| Provider Information | |||||||||
| NPI: | 1104166297 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLOWERS-GUERRERO | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3133 N. MILLBROOK AVE. | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596008918 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3133 N. MILLBROOK AVE. | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596008918 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2013 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 119133 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.