Provider Demographics
NPI:1003477225
Name:BARFOOT, IRENE (CMT)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:BARFOOT
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:MARIA IRENE
Other - Middle Name:
Other - Last Name:BARFOOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMT
Mailing Address - Street 1:1145 CARLSBAD DR APT 1
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3207
Mailing Address - Country:US
Mailing Address - Phone:408-406-5782
Mailing Address - Fax:
Practice Address - Street 1:10090 PASADENA AVE STE B2
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5939
Practice Address - Country:US
Practice Address - Phone:408-406-5782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27064225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist