Provider Demographics
NPI:1700084597
Name:GREENE, BARBARA J (COM)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:GREENE
Suffix:
Gender:F
Credentials:COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 W CARMEL GRN
Mailing Address - Street 2:
Mailing Address - City:PORT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93041-1806
Mailing Address - Country:US
Mailing Address - Phone:805-452-4302
Mailing Address - Fax:425-988-9447
Practice Address - Street 1:1801 SOLAR DR
Practice Address - Street 2:SUITE 155
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-8234
Practice Address - Country:US
Practice Address - Phone:805-452-4302
Practice Address - Fax:425-988-9447
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor