Provider Demographics
NPI:1255992285
Name:SA, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SA
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 1:5203 W WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-3466
Mailing Address - Country:US
Mailing Address - Phone:559-625-9888
Mailing Address - Fax:
Practice Address - Street 1:5203 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-3466
Practice Address - Country:US
Practice Address - Phone:559-625-9888
Practice Address - Fax:559-625-9580
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist