Healthcare Provider Details

I. General information

NPI: 1104991520
Provider Name (Legal Business Name): VAL L BARRON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W 17TH ST STE 101N
SANTA ANA CA
92706-2316
US

IV. Provider business mailing address

2865 CALLE HERALDO
SAN CLEMENTE CA
92673-3536
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-7779
  • Fax: 714-834-8372
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number505957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: