Provider Demographics
NPI:1780083931
Name:BARACH, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BARACH
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 1:2050 NUT TREE RD
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-7108
Mailing Address - Country:US
Mailing Address - Phone:707-301-4282
Mailing Address - Fax:707-301-4053
Practice Address - Street 1:2050 NUT TREE RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-7108
Practice Address - Country:US
Practice Address - Phone:707-301-4282
Practice Address - Fax:707-301-4053
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67039183500000X
FLPS39731183500000X
PARP447521183500000X
IL051.031513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist