MEDICARE: MS. JACQUELINE ADRIANA BARBOSA PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1740135714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JACQUELINE ADRIANA BARBOSA PA-C

Provider Business Mailing Address
First Line	:	624 N KENWOOD ST
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-3108
Country	:	US
Telephone Number	:	818-751-3312
Fax Number	:

Provider Business Practice Location Address
First Line	:	13193 CENTRAL AVE
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-4179
Country	:	US
Telephone Number	:	909-464-9675
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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