Healthcare Provider Details

I. General information

NPI: 1831022490
Provider Name (Legal Business Name): MRS. BIANCA BARRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. BIANCA MASTERS

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 CAMPUS COMMONS DR
RESTON VA
20191-1519
US

IV. Provider business mailing address

5110 BROADWAY # 1005
WOODSIDE NY
11377-1729
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-9680
  • Fax:
Mailing address:
  • Phone: 646-974-8634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: