MEDICARE: JOAN ISABELLE BARCENAS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95028163	CA
2	363L00000X	Nurse Practitioner	95028163	CA

General Provider Information

NPI Number	:	1285479261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN ISABELLE BARCENAS NP

Provider Business Mailing Address
First Line	:	4810 SAWTELLE BLVD APT 3
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90230-4987
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1831 WILSHIRE BLVD STE B
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5778
Country	:	US
Telephone Number	:	310-829-8441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	12/17/2024

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