Provider Demographics
NPI:1003129164
Name:BARRAZA, NUBIA GISSEY
Entity type:Individual
Prefix:
First Name:NUBIA
Middle Name:GISSEY
Last Name:BARRAZA
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 1:2440 ARLINE ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-2164
Mailing Address - Country:US
Mailing Address - Phone:626-392-8050
Mailing Address - Fax:
Practice Address - Street 1:2440 ARLINE ST
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-2164
Practice Address - Country:US
Practice Address - Phone:626-392-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner