Provider Demographics
NPI:1255964854
Name:YBARRA, STEPHANIE JANAE (CPO, CFM)
Entity type:Individual
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First Name:STEPHANIE
Middle Name:JANAE
Last Name:YBARRA
Suffix:
Gender:F
Credentials:CPO, CFM
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Mailing Address - Street 1:5412 AVENIDA DE LOS ROBLES
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291
Mailing Address - Country:US
Mailing Address - Phone:559-636-3800
Mailing Address - Fax:559-636-3802
Practice Address - Street 1:5412 AVENIDA DE LOS ROBLES
Practice Address - Street 2:SUITE 101
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291
Practice Address - Country:US
Practice Address - Phone:559-636-3800
Practice Address - Fax:559-636-3802
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist