Provider Demographics
NPI:1225866601
Name:BARICAN, JERONNEL (RN)
Entity type:Individual
Prefix:MR
First Name:JERONNEL
Middle Name:
Last Name:BARICAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 QUIMBY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1531
Mailing Address - Country:US
Mailing Address - Phone:818-257-8014
Mailing Address - Fax:
Practice Address - Street 1:23388 MULHOLLAND DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2733
Practice Address - Country:US
Practice Address - Phone:818-876-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95270878163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health