=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750189106
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA RASMUSSEN PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2025
-----------------------------------------------------
Last Update Date | 03/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1809 W REDLANDS BLVD
-----------------------------------------------------
City | REDLANDS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92373-8054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-289-4075
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4966 BALSA AVE
-----------------------------------------------------
City | YUCCA VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92284-6631
-----------------------------------------------------
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 | 95033859
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------