1265419170 NPI number — RUTH ANNE BARRERA R.N.; N.P.

Table of content: RUTH ANNE BARRERA R.N.; N.P. (NPI 1265419170)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265419170 NPI number — RUTH ANNE BARRERA R.N.; N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRERA
Provider First Name:
RUTH
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.N.; N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265419170
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3812 N 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93726-4301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-495-3120
Provider Business Mailing Address Fax Number:
559-495-3134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2944 FRESNO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93721-1405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-497-7900
Provider Business Practice Location Address Fax Number:
559-497-6019
Provider Enumeration Date:
12/30/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  358706 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LX0001X , with the licence number: 8722 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 358706 . This is a "REGISTERED NURSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 8722 . This is a "NURSE PRACTITIONER FURN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".