Provider Demographics
NPI:1164839908
Name:GUADERRAMA, ANA KAREN (LCSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:KAREN
Last Name:GUADERRAMA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 CAMINO DEL RIO N STE 700
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-5708
Mailing Address - Country:US
Mailing Address - Phone:619-235-0120
Mailing Address - Fax:
Practice Address - Street 1:3131 CAMINO DEL RIO N STE 700
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-5708
Practice Address - Country:US
Practice Address - Phone:619-235-0120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA12225621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health