=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568272912
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARINA MARIANA BARAJAS LOZA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2025
-----------------------------------------------------
Last Update Date | 04/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 421 N BROOKHURST ST
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92801-5637
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-361-0898
-----------------------------------------------------
Fax | 714-276-2604
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10610 MOUNTAIN VIEW AVE APT A
-----------------------------------------------------
City | REDLANDS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92373-8424
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 95032692
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------