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General NPI Number Information
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NPI Number | 1811873060
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Entity Type | Individual
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Provider Name | EDIN R BARRERA
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Gender | Male
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 508 POPLAR AVE
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-2555
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Country | US
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Telephone | 916-375-7720
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Fax |
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Provider Business Mailing Address
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Address Line | 505 POPLAR AVE
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-2554
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Country | US
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Telephone | 561-558-4469
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | CA
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