Provider Demographics
NPI:1629855325
Name:BARBOSA, NORMA C
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:C
Last Name:BARBOSA
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 1:6522 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-1323
Mailing Address - Country:US
Mailing Address - Phone:951-545-8045
Mailing Address - Fax:
Practice Address - Street 1:4244 RIVERWALK PKWY STE 150
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3373
Practice Address - Country:US
Practice Address - Phone:951-781-6335
Practice Address - Fax:951-781-6365
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker