Healthcare Provider Details

I. General information

NPI: 1922987767
Provider Name (Legal Business Name): ANADELIA MIREYA BARRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10154 PRINCESS JOANN RD
SANTEE CA
92071-1171
US

IV. Provider business mailing address

10154 PRINCESS JOANN RD
SANTEE CA
92071-1171
US

V. Phone/Fax

Practice location:
  • Phone: 509-781-2617
  • Fax:
Mailing address:
  • Phone: 509-781-2617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: