Individual provider Active NPI

Jacqueline Carina Guerra, M.D.

  • Internal Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1649685074
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A151449 Issued in CA
Practice address
122 S Patterson Ave
Santa Barbara, CA 93111-2055
Phone
(805) 681-1744
Fax
(805) 681-1744
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A151449 CA Primary

Addresses

Primary practice location

122 S Patterson Ave
Santa Barbara, CA 93111-2055

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1744

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321

Other identifiers 2

IdentifierTypeStateIssuer
A151449OtherCA1649685074
A151449OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171213002508 CA Practitioner - Internal Medicine 6204194673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Town Ctr Pkwy
Santee, CA 92071-5801
Phone (619) 662-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A151449CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Jan 29, 2020 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Dec 1, 2020 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jan 29, 2020 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1111 W Chase Ave
El Cajon, CA 92020
Phone (619) 515-2499

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

120 Town Center Pkwy
Santee, CA 92071
Phone (619) 645-0111

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1649685074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1744",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S PATTERSON AVE",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931112055",
            "telephone_number": "805-681-1744",
            "fax_number": "805-681-1744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "JACQUELINE",
        "middle_name": "CARINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A151449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1649685074",
            "identifier": "A151449",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A151449",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.