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1508678194 NPI number — ANNETTE BARNES P.A.

NPI Number: 1508678194
Health Care Provider/Practitioner: ANNETTE BARNES P.A.

Information about “1508678194” NPI (ANNETTE BARNES P.A.) exists in 1508678194 in HTML format HTML  |  1508678194 in plain Text format TXT  |  1508678194 in PDF (Portable Document Format) PDF  |  1508678194 in an XML format XML  formats.

NPI Number : 1508678194 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508678194",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BARNES",
    "FirstName": "ANNETTE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "P.A.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8066 LINARES AVENUE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RIVERSIDE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92509",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "510-367-2533",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "SHASA MEDICAL GROUP MEDICAL DIRECTOR: MILLIADAIRE SYVER",
    "SecondLinePracticeLocationAddress": "88 TULLY ROAD, SUITE 110",
    "PracticeLocationAddressCityName": "SAN JOSE",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95111",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "408-294-9234",
    "PracticeLocationAddressFaxNumber": "408-564-5868",
    "EnumerationDate": "01/22/2025",
    "LastUpdateDate": "01/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363AM0700X",
        "TaxonomyName": "Medical Physician Assistant",
        "LicenseNumber": "PA13805",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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