Provider Demographics
NPI:1104239870
Name:ROSS, BARBARA ELIZABETH (DPM)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELIZABETH
Last Name:ROSS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ELIZABETH
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:3800 J. STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:916-453-8900
Mailing Address - Fax:916-454-4359
Practice Address - Street 1:5 MEDICAL PLAZA DR.
Practice Address - Street 2:SUITE 110
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-782-3444
Practice Address - Fax:916-782-3490
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5327213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery