Healthcare Provider Details

I. General information

NPI: 1306537378
Provider Name (Legal Business Name): BELINDA MONICA BARRAZA AGUILAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 FRESNO ST
FRESNO CA
93706-3235
US

IV. Provider business mailing address

9323 N SAYBROOK DR APT 241
FRESNO CA
93720-0835
US

V. Phone/Fax

Practice location:
  • Phone: 559-441-0998
  • Fax: 559-441-1088
Mailing address:
  • Phone: 831-210-8202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number141964
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: