Healthcare Provider Details

I. General information

NPI: 1922246370
Provider Name (Legal Business Name): BARBARA ANN HARYN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 E LOS ANGELES AVE
SIMI VALLEY CA
93065-3940
US

IV. Provider business mailing address

3150 E LOS ANGELES AVE
SIMI VALLEY CA
93065-3940
US

V. Phone/Fax

Practice location:
  • Phone: 805-577-0830
  • Fax: 805-581-2852
Mailing address:
  • Phone: 805-577-0830
  • Fax: 805-581-2852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number382282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: