Provider Demographics
NPI:1407145477
Name:BARRETTO, NAYABEI (NP)
Entity Type:Individual
Prefix:
First Name:NAYABEI
Middle Name:
Last Name:BARRETTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NAYABEI
Other - Middle Name:
Other - Last Name:VANWOERKOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1815 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-3202
Mailing Address - Country:US
Mailing Address - Phone:707-542-9644
Mailing Address - Fax:707-737-0224
Practice Address - Street 1:1815 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-3202
Practice Address - Country:US
Practice Address - Phone:707-542-9644
Practice Address - Fax:707-737-0224
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002779363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA183840Medicare PIN