MEDICARE: SANDRA BARRERA

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	1041C0700X	Clinical Social Worker	109580	TX
2	1041C0700X	Clinical Social Worker	L16996	OR

General Provider Information

NPI Number	:	1326922691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA BARRERA

Provider Business Mailing Address
First Line	:	1510 SW ALDER ST APT 617
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-1524
Country	:	US
Telephone Number	:	512-956-8014
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 SW ALDER ST APT 617
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-1524
Country	:	US
Telephone Number	:	956-245-4803
Fax Number	:

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

Provider Enumeration Date	:	07/31/2025
Last Update Date	:	09/29/2025

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Directions to “ SANDRA BARRERA ” Practice Location

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