Provider Demographics
NPI:1104422823
Name:DEMMAN, BARBARA (NP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:DEMMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3879 SHERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5034
Mailing Address - Country:US
Mailing Address - Phone:714-412-3606
Mailing Address - Fax:
Practice Address - Street 1:6133 BRISTOL PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6613
Practice Address - Country:US
Practice Address - Phone:310-338-1267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18402363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner