Provider Demographics
NPI:1023680717
Name:GUERRERO, JOSUE R (CADC-R)
Entity type:Individual
Prefix:
First Name:JOSUE
Middle Name:R
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:CADC-R
Other - Prefix:
Other - First Name:JOSH
Other - Middle Name:R
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC-R
Mailing Address - Street 1:300 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-2756
Mailing Address - Country:US
Mailing Address - Phone:541-772-1777
Mailing Address - Fax:
Practice Address - Street 1:300 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-2756
Practice Address - Country:US
Practice Address - Phone:541-772-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTHW000004092175T00000X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist