Provider Demographics
NPI:1245314582
Name:BARRERA, JENIFFER KAREN (DNP)
Entity type:Individual
Prefix:
First Name:JENIFFER
Middle Name:KAREN
Last Name:BARRERA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MOUNTAIN VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-4614
Mailing Address - Country:US
Mailing Address - Phone:510-388-6281
Mailing Address - Fax:
Practice Address - Street 1:81 MOUNTAIN VALLEY ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-4614
Practice Address - Country:US
Practice Address - Phone:510-388-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA579386163W00000X
CA12379363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse