Healthcare Provider Details

I. General information

NPI: 1235083908
Provider Name (Legal Business Name): ROMAINE SANTIAGO BARRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 4TH ST STE 130
RANCHO CUCAMONGA CA
91730-5808
US

IV. Provider business mailing address

244 W ARROW HWY APT 4
UPLAND CA
91786-5267
US

V. Phone/Fax

Practice location:
  • Phone: 909-320-2011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: