Provider Demographics
NPI:1821830670
Name:BARRAZA, ADRIENNE MARIE (FNP)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MARIE
Last Name:BARRAZA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:MARIE
Other - Last Name:SANDOVAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:12294 CHARLTON RD
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8552
Mailing Address - Country:US
Mailing Address - Phone:559-871-0300
Mailing Address - Fax:
Practice Address - Street 1:12294 CHARLTON RD
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8552
Practice Address - Country:US
Practice Address - Phone:559-871-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030291363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily