Provider Demographics
NPI:1285811620
Name:BARRAZA, TANYA GRISSELL
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:GRISSELL
Last Name:BARRAZA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TANYA
Other - Middle Name:GRISSELL
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10155 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2042
Mailing Address - Country:US
Mailing Address - Phone:562-692-0383
Mailing Address - Fax:
Practice Address - Street 1:10155 COLIMA RD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2042
Practice Address - Country:US
Practice Address - Phone:562-692-0383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program