Individual provider Active NPI

Kiana Guerrero, M.D.

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1790217594
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A158485 Issued in CA
Practice address
3883 Airway Dr Ste 202
Santa Rosa, CA 95403-1671
Phone
(707) 303-3600
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A158485 CA Primary

Addresses

Primary practice location

3883 Airway Dr Ste 202
Santa Rosa, CA 95403-1671

Mailing address

19270 Sonoma Hwy
Sonoma, CA 95476
Phone (707) 939-6070

Other practice location 1

3569 Round Barn Cir Ste 200
Santa Rosa, CA 95403-5781
Phone (707) 583-8800

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
I20210106001002 CA Practitioner - Family Practice 0840603171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Sonoma Valley Community Health CenterGroup PAC ID 6800708686, 16 clinicians

Practice addresses (Care Compare)

19270 Hwy 12
Sonoma, CA 95476-5414
Phone (707) 939-6070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158485CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoma Valley Community Health Center CurrentSince Jan 11, 2021 Accepting new patients
Sutter West Bay Medical Foundation Family Medicine Past Accepting new patients

Locations

19270 Highway 12
Sonoma, CA 95476
Phone (707) 939-6070

Interoperability endpoints

  • Direct secure messaging: kguerreromccormick645303@direct.ochin.org

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.

Hospital & facility affiliations 2

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1790217594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19270 SONOMA HWY",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "95476",
            "telephone_number": "707-939-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR STE 202",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031671",
            "telephone_number": "707-303-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3569 Round Barn Cir Ste 200",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954035781",
            "country_code": "US",
            "telephone_number": "707-583-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "KIANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A158485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.