1871733360 NPI number — MRS. LORETTE ELISE BARBA CPNP

Table of content: MRS. LORETTE ELISE BARBA CPNP (NPI 1871733360)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871733360 NPI number — MRS. LORETTE ELISE BARBA CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARBA
Provider First Name:
LORETTE
Provider Middle Name:
ELISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LONG
Provider Other First Name:
LAURIE(NICK NAME)
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871733360
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7227 GLENVIEW DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95120-5808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-927-7475
Provider Business Mailing Address Fax Number:
408-440-0043

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2505 SAMARITAN DRIVE SUITE #607
Provider Second Line Business Practice Location Address:
SILICON VALLEY PEDIATRICIANS
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-356-9900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/24/2009

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: 363L00000X , with the licence number:  257702 , 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)