Healthcare Provider Details

I. General information

NPI: 1053845438
Provider Name (Legal Business Name): MARIANNE BARRINUEVO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 CAMINO DEL REMEDIO
SANTA BARBARA CA
93110-1332
US

IV. Provider business mailing address

315 CAMINO DEL REMEDIO
SANTA BARBARA CA
93110-1332
US

V. Phone/Fax

Practice location:
  • Phone: 805-722-7461
  • Fax:
Mailing address:
  • Phone: 805-722-7461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number655155
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: