Provider Demographics
NPI:1710287537
Name:BARNES, HEATHER ANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:BARNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 N VINE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-3713
Mailing Address - Country:US
Mailing Address - Phone:323-466-7158
Mailing Address - Fax:323-461-2684
Practice Address - Street 1:727 N VINE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-3713
Practice Address - Country:US
Practice Address - Phone:323-466-7158
Practice Address - Fax:323-461-2684
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist