Provider Demographics
NPI:1255140695
Name:BARRAGAN, MARLENNE
Entity type:Individual
Prefix:
First Name:MARLENNE
Middle Name:
Last Name:BARRAGAN
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 1:1441 CONSTITUTION BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3127
Mailing Address - Country:US
Mailing Address - Phone:831-755-5505
Mailing Address - Fax:831-796-8686
Practice Address - Street 1:1441 CONSTITUTION BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3127
Practice Address - Country:US
Practice Address - Phone:831-755-5505
Practice Address - Fax:831-796-8686
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical