Healthcare Provider Details

I. General information

NPI: 1457633091
Provider Name (Legal Business Name): VANESSA BARIENBROCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 PAGE MILL RD STE 103
PALO ALTO CA
94306-2073
US

IV. Provider business mailing address

195 PAGE MILL RD STE 103
PALO ALTO CA
94306-2073
US

V. Phone/Fax

Practice location:
  • Phone: 949-654-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number21110
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1955
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number753585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: