Monica A Guerrero Lara

Primary specialty

AudiologistTaxonomy code 231H00000X

Practice address

1620 Pennsylvania Ave Ste D
Fairfield, CA 94533-3509

Phone

(707) 624-2703

Fax

(707) 426-5190

NPI assigned

Mar 27, 2020

Last updated

Jan 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Pine River Inc.

  dba Hearing Services

  • Audiologist
  • Fairfield, CA
  • NPI 1639394117
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Pine River Inc

  • Audiologist
  • Fairfield, CA
  • NPI 1598126161
  NPD (past)

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1528696465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 PENNSYLVANIA AVE STE D",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333509",
            "telephone_number": "707-624-2703",
            "fax_number": "707-426-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 PENNSYLVANIA AVE STE D",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333509",
            "telephone_number": "707-624-2703",
            "fax_number": "707-426-5190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "673 Merchant St Ste B",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956886952",
            "country_code": "US",
            "telephone_number": "707-446-0742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "480 Redwood St Ste 14",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945902958",
            "country_code": "US",
            "telephone_number": "707-642-8815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRERO LARA",
        "first_name": "MONICA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2022-01-03",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "8612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mathilda Luisa Grosse
• Christopher David Grover
• Robert Groves, LMT
• Raphaelle Gruys, CMT
• John S. Guerrant Jr., MD
• Alejandro Miguel Guerrero, M.S.
• Macauley Guerrero
• Janae Guess
• Angelo Guevarra
• Nicole Diahanne Guggemos

• Audiologist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.