Healthcare Provider Details

I. General information

NPI: 1417146499
Provider Name (Legal Business Name): PATRICIA BARRAZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8531 CHINCHILLA LN
EL PASO TX
79907-5209
US

IV. Provider business mailing address

8531 CHINCHILLA LN
EL PASO TX
79907-5209
US

V. Phone/Fax

Practice location:
  • Phone: 915-479-2573
  • Fax:
Mailing address:
  • Phone: 915-479-2573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: