Healthcare Provider Details

I. General information

NPI: 1962641399
Provider Name (Legal Business Name): KATHRYN CORINNE BARKER ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 02/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OUTLET CENTER DR STE 220
OXNARD CA
93036-0607
US

IV. Provider business mailing address

441 N PASS AVE APT 36
BURBANK CA
91505-3338
US

V. Phone/Fax

Practice location:
  • Phone: 312-804-5125
  • Fax:
Mailing address:
  • Phone: 818-433-7514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: