MEDICARE: PATRICIA BARRERA PHD

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	103TC0700X	Clinical Psychologist	PY228	NV

General Provider Information

NPI Number	:	1457565434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA BARRERA PHD

Provider Business Mailing Address
First Line	:	701 N GREEN VALLEY PKWY
Second Line	:	SUITE 200
City	:	HENDERSON
State	:	NV
Zip	:	89074-6177
Country	:	US
Telephone Number	:	702-952-2894
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 N GREEN VALLEY PKWY
Second Line	:	SUITE 200
City	:	HENDERSON
State	:	NV
Zip	:	89074-6177
Country	:	US
Telephone Number	:	702-952-2894
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	11/30/2007

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