Provider Demographics
NPI:1083251151
Name:BARBOZA, URSULA ANDREA (RN)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:ANDREA
Last Name:BARBOZA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:URSULA
Other - Middle Name:ANDREA
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:637 SUMNER WAY UNIT 5
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-0660
Mailing Address - Country:US
Mailing Address - Phone:760-803-9509
Mailing Address - Fax:
Practice Address - Street 1:637 SUMNER WAY UNIT 5
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-0660
Practice Address - Country:US
Practice Address - Phone:760-803-9509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-07
Last Update Date:2019-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95147603163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse