Individual provider Active NPI

Susan Evbuomwan Guerrero, MFT

  • Marriage & Family Therapist
  • Yorba Linda, CA
National Provider Identifier
1265095574
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
141140 Issued in CA
Practice address
18200 Yorba Linda Blvd Ste 106
Yorba Linda, CA 92886-4006
Phone
(714) 646-8034
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 141140 CA Primary

Addresses

Primary practice location

18200 Yorba Linda Blvd Ste 106
Yorba Linda, CA 92886-4006

Mailing address

385 S Manchester Ave Unit 1046
Orange, CA 92868-3238

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chiron Psychological, Inc Marriage & Family Therapist CurrentSince Sep 5, 2023 Accepting new patients
County of Orange Past Accepting new patients

Locations

18200 Yorba Linda Blvd
Ste 106
Yorba Linda, CA 92886
Phone (714) 646-8034

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1265095574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 S MANCHESTER AVE UNIT 1046",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18200 YORBA LINDA BLVD STE 106",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864006",
            "telephone_number": "714-646-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "SUSAN",
        "middle_name": "EVBUOMWAN",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2023-08-29",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.