Provider Demographics
NPI:1346761780
Name:BARAHONA, ROSALIA JUANITA
Entity Type:Individual
Prefix:
First Name:ROSALIA
Middle Name:JUANITA
Last Name:BARAHONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38350 40TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-3075
Mailing Address - Country:US
Mailing Address - Phone:661-225-3000
Mailing Address - Fax:
Practice Address - Street 1:38350 40TH ST E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-3075
Practice Address - Country:US
Practice Address - Phone:661-225-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA834829163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care