Provider Demographics
NPI:1902843410
Name:YBARRA, SANDRA K (FNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:YBARRA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:K
Other - Last Name:YBARRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PAC
Mailing Address - Street 1:10049 RUBICON CT
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-2803
Mailing Address - Country:US
Mailing Address - Phone:805-647-0676
Mailing Address - Fax:
Practice Address - Street 1:EHS 800 S VICTORIA
Practice Address - Street 2:SBCH-ED PUEBO @BATH, SANTA BARBARA, CA ED
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93009-1150
Practice Address - Country:US
Practice Address - Phone:805-654-3814
Practice Address - Fax:805-654-5028
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10068 / RN446139363L00000X
CAPA22219363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN446139Medicaid
CAWNP10068CMedicare PIN
CARN446139Medicaid
CAS73425Medicare UPIN