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General NPI Number Information
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NPI Number | 1184958696
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Entity Type | Individual
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Provider Name | KALANETE R BARUCH NP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 3569 ROUND BARN CIR
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City | SANTA ROSA
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State | CA
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Zip | 95403-5781
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Country | US
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Telephone | 707-303-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 HARRISON ST FL 7
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City | OAKLAND
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State | CA
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Zip | 94612-3466
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Country | US
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Telephone | 510-625-4101
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Fax | 877-738-4262
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 760114
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | LM36
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95000850
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License Number State | CA
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