Provider Demographics
NPI:1528883253
Name:BARRIOS, LUZ RUBY (CMT)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:RUBY
Last Name:BARRIOS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-2302
Mailing Address - Country:US
Mailing Address - Phone:925-421-3594
Mailing Address - Fax:
Practice Address - Street 1:2411 SANTA CLARA AVE STE 24
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4543
Practice Address - Country:US
Practice Address - Phone:925-421-3594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88749225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist