Provider Demographics
NPI:1821723891
Name:BARRERA, ANAIS (PA)
Entity type:Individual
Prefix:MRS
First Name:ANAIS
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7699 E PINNACLE PEAK RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6322
Mailing Address - Country:US
Mailing Address - Phone:803-004-6634
Mailing Address - Fax:480-300-4888
Practice Address - Street 1:7699 E PINNACLE PEAK RD STE 115
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6322
Practice Address - Country:US
Practice Address - Phone:480-300-4663
Practice Address - Fax:480-300-4888
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10291363A00000X
TX1325-P.A.363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty