Provider Demographics
NPI:1467648253
Name:BARRAGAN, MARIA SUSANA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SUSANA
Last Name:BARRAGAN
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 1:12700 ELLIOTT AVE SPC 356
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-4132
Mailing Address - Country:US
Mailing Address - Phone:626-230-9298
Mailing Address - Fax:
Practice Address - Street 1:3115 RED HILL AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4517
Practice Address - Country:US
Practice Address - Phone:714-850-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker