Provider Demographics
NPI:1063108504
Name:BARRERA, MAGGIE LEILANI I
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:LEILANI
Last Name:BARRERA
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-5400
Mailing Address - Country:US
Mailing Address - Phone:805-265-4894
Mailing Address - Fax:805-856-0343
Practice Address - Street 1:216 MONTEBELLO AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-1620
Practice Address - Country:US
Practice Address - Phone:805-572-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other