Active NPI
Edward Kenneth Guerrero III, MSW
- Clinical Social Worker
- Pomona, CA
National Provider Identifier
1255933974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 105637
- Practice address
- 625 S Garey Ave
Pomona, CA 91766-3322 - Phone
- (626) 662-3027
- NPI assigned
- Nov 9, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 105637 | Primary |
Addresses
Primary practice location
625 S Garey Ave
Pomona, CA 91766-3322
Mailing address
762 Cypress St
San Dimas, CA 91773-3505
Other practice location 1
762 Cypress St
San Dimas, CA 91773-3505
Phone (909) 599-1227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1255933974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "762 CYPRESS ST",
"city": "SAN DIMAS",
"state": "CA",
"postal_code": "917733505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 S GAREY AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917663322",
"telephone_number": "626-662-3027"
}
],
"practiceLocations": [
{
"address_1": "762 Cypress St",
"address_purpose": "LOCATION",
"city": "San Dimas",
"state": "CA",
"postal_code": "917733505",
"country_code": "US",
"telephone_number": "909-599-1227",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUERRERO",
"first_name": "EDWARD",
"middle_name": "KENNETH",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-09",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": "105637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.