Provider Demographics
NPI:1376970863
Name:BARNES, RICKI K (PA-C)
Entity Type:Individual
Prefix:
First Name:RICKI
Middle Name:K
Last Name:BARNES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-3011
Mailing Address - Country:US
Mailing Address - Phone:661-725-1010
Mailing Address - Fax:661-725-1144
Practice Address - Street 1:1500 6TH AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3011
Practice Address - Country:US
Practice Address - Phone:661-725-1010
Practice Address - Fax:661-725-1144
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22961227800000X
CAPA23294363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified