Provider Demographics
NPI:1255158606
Name:BARRENA, CASSANDRA FAY
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:FAY
Last Name:BARRENA
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 1:2374 PARMABELLE RD
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-9749
Mailing Address - Country:US
Mailing Address - Phone:209-347-7771
Mailing Address - Fax:
Practice Address - Street 1:5379 CA-49
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338
Practice Address - Country:US
Practice Address - Phone:209-347-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA534138163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse