Healthcare Provider Details

I. General information

NPI: 1831415736
Provider Name (Legal Business Name): MARIA NOELLE BARRELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2010
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date: 10/31/2018
Reactivation Date: 11/21/2018

III. Provider practice location address

2772 JOHNSON DR STE 100
VENTURA CA
93003-7261
US

IV. Provider business mailing address

3555 LOMA VISTA RD STE 110
VENTURA CA
93003-3161
US

V. Phone/Fax

Practice location:
  • Phone: 805-642-1430
  • Fax: 833-916-2136
Mailing address:
  • Phone: 805-653-0303
  • Fax: 805-653-5761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A13136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: