Provider Demographics
NPI:1366954596
Name:GUEVARRA, MERCY ALFONSO
Entity type:Individual
Prefix:
First Name:MERCY
Middle Name:ALFONSO
Last Name:GUEVARRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 WATT AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3614
Mailing Address - Country:US
Mailing Address - Phone:916-487-3719
Mailing Address - Fax:916-993-8002
Practice Address - Street 1:3180 WATT AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-3614
Practice Address - Country:US
Practice Address - Phone:916-487-3719
Practice Address - Fax:916-993-8002
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility