Provider Demographics
NPI:1679528897
Name:GUERRA, BILLIE YVONNE (DO)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:YVONNE
Last Name:GUERRA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:YVONNE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1081 N CHINA LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3130
Mailing Address - Country:US
Mailing Address - Phone:760-499-3855
Mailing Address - Fax:760-499-3870
Practice Address - Street 1:1011 N CHINA LAKE BLVD
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3130
Practice Address - Country:US
Practice Address - Phone:760-499-3640
Practice Address - Fax:760-499-7229
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8965207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A89650Medicare ID - Type Unspecified
I49159Medicare UPIN