Provider Demographics
NPI:1407270945
Name:BARRIENTOS, ELY
Entity Type:Individual
Prefix:
First Name:ELY
Middle Name:
Last Name:BARRIENTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 EDDY ST APT 205
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-7847
Mailing Address - Country:US
Mailing Address - Phone:415-353-5657
Mailing Address - Fax:
Practice Address - Street 1:730 EDDY ST APT 205
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-7847
Practice Address - Country:US
Practice Address - Phone:415-353-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker