Healthcare Provider Details

I. General information

NPI: 1285382226
Provider Name (Legal Business Name): IRMA LYNN BARRIENTOS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 MISSION AVE STE 230
OCEANSIDE CA
92058-7110
US

IV. Provider business mailing address

436 CALICO RD
OCEANSIDE CA
92058-6748
US

V. Phone/Fax

Practice location:
  • Phone: 760-712-3535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number685018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: