Provider Demographics
NPI:1467094672
Name:WARNER, BARBARA DENISE
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:DENISE
Last Name:WARNER
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 1:307 DENTON RD
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:CA
Mailing Address - Zip Code:95323-9703
Mailing Address - Country:US
Mailing Address - Phone:209-401-6586
Mailing Address - Fax:
Practice Address - Street 1:307 DENTON RD
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:CA
Practice Address - Zip Code:95323-9703
Practice Address - Country:US
Practice Address - Phone:209-401-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA