Provider Demographics
NPI:1285911099
Name:BARRERA, MARIA SANDRA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:SANDRA
Last Name:BARRERA
Suffix:
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 1:420 SO. SAN PEDRO STREET SUITE G-3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013
Mailing Address - Country:US
Mailing Address - Phone:213-633-2900
Mailing Address - Fax:213-617-9765
Practice Address - Street 1:420 S SAN PEDRO ST STE G3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1938
Practice Address - Country:US
Practice Address - Phone:213-633-2900
Practice Address - Fax:213-617-9765
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator