MEDICARE: MARIBEL BARRAGAN PH.D.

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1760224240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL BARRAGAN PH.D.

Provider Business Mailing Address
First Line	:	5560 W CROMWELL AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-2714
Country	:	US
Telephone Number	:	559-281-5748
Fax Number	:

Provider Business Practice Location Address
First Line	:	5614 N FRESNO ST STE 118
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-6034
Country	:	US
Telephone Number	:	559-281-5748
Fax Number	:

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

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	06/06/2024

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