Provider Demographics
NPI:1700394756
Name:BARRAZA, ROBERTA (RNFA)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:BARRAZA
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:
Other - Last Name:BARRAZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNFA
Mailing Address - Street 1:9603 BORSON ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-4927
Mailing Address - Country:US
Mailing Address - Phone:323-533-9922
Mailing Address - Fax:
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1701
Practice Address - Country:US
Practice Address - Phone:562-933-3361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA644628163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant