Provider Demographics
NPI:1598518482
Name:BARAKAT, ABDULFATAH ADNAN (FNP)
Entity Type:Individual
Prefix:MR
First Name:ABDULFATAH
Middle Name:ADNAN
Last Name:BARAKAT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 PICKWICK DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6427
Mailing Address - Country:US
Mailing Address - Phone:805-484-7448
Mailing Address - Fax:
Practice Address - Street 1:2103 PICKWICK DR
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6427
Practice Address - Country:US
Practice Address - Phone:805-484-7448
Practice Address - Fax:805-484-3642
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily