Provider Demographics
NPI:1225317985
Name:BARBELLA, SALLY T (NP)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:T
Last Name:BARBELLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3110 PARK NEWPORT APT 410
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5847
Mailing Address - Country:US
Mailing Address - Phone:949-584-1739
Mailing Address - Fax:949-220-0886
Practice Address - Street 1:3110 PARK NEWPORT APT 410
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5847
Practice Address - Country:US
Practice Address - Phone:949-584-1739
Practice Address - Fax:949-220-0886
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP14062363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily