Healthcare Provider Details

I. General information

NPI: 1578962064
Provider Name (Legal Business Name): MRS. GUADALUPE GUILLERMINA BARATTINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. GUADALUPE GUILLERMINA ORTIZ

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 08/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 PACIFIC AVE
LIVERMORE CA
94550-7007
US

IV. Provider business mailing address

1415 FRUITVALE AVE
OAKLAND CA
94601-2320
US

V. Phone/Fax

Practice location:
  • Phone: 925-961-8045
  • Fax: 925-951-8835
Mailing address:
  • Phone: 510-535-8400
  • Fax: 510-535-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: