Provider Demographics
NPI:1578033221
Name:BARRAZA, KRISTI ANN (BS, QMHP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:ANN
Last Name:BARRAZA
Suffix:
Gender:F
Credentials:BS, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-3121
Mailing Address - Country:US
Mailing Address - Phone:541-889-9167
Mailing Address - Fax:541-889-7873
Practice Address - Street 1:702 SUNSET DR
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-3121
Practice Address - Country:US
Practice Address - Phone:541-889-9167
Practice Address - Fax:541-889-7873
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health