Healthcare Provider Details

I. General information

NPI: 1396183109
Provider Name (Legal Business Name): MS. ROSALINDA BARAJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2013
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 7TH ST
MADERA CA
93638-3780
US

IV. Provider business mailing address

430 W LOCUST AVE
FRESNO CA
93650-1128
US

V. Phone/Fax

Practice location:
  • Phone: 559-673-3058
  • Fax:
Mailing address:
  • Phone: 559-444-3075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: