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General NPI Number Information
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NPI Number | 1326683582
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Entity Type | Individual
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Provider Name | WENDY KARINA BARRETO II
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Gender | Female
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 999 SAN BERNARDINO RD
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City | UPLAND
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State | CA
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Zip | 91786-4920
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Country | US
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Telephone | 909-781-9042
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Fax |
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Provider Business Mailing Address
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Address Line | 123 W HOLT BLVD UNIT 11
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City | ONTARIO
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State | CA
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Zip | 91762-7801
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Country | US
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Telephone | 909-458-1396
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D4145882
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License Number State | CA
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