Provider Demographics
NPI:1790448678
Name:BARRANTES, ROMMEL
Entity type:Individual
Prefix:
First Name:ROMMEL
Middle Name:
Last Name:BARRANTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 E IMPERIAL HWY # 124
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-8513
Mailing Address - Country:US
Mailing Address - Phone:714-773-0077
Mailing Address - Fax:714-773-0067
Practice Address - Street 1:524 E IMPERIAL HWY # 124
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-8513
Practice Address - Country:US
Practice Address - Phone:714-773-0077
Practice Address - Fax:714-773-0067
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician