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General NPI Number Information
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NPI Number | 1841148426
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Entity Type | Individual
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Provider Name | BRENDA IBARRA VAZQUEZ
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Gender | Female
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 3700 HILBORN RD STE 950
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City | FAIRFIELD
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State | CA
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Zip | 94534-7999
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Country | US
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Telephone | 707-639-1138
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Fax |
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Provider Business Mailing Address
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Address Line | 126 HAVEN CT
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City | VALLEJO
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State | CA
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Zip | 94591-5525
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Country | US
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Telephone | 707-704-5116
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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