Provider Demographics
NPI:1164107009
Name:CONTRERAS BARRERA, SOLEDAD (PA)
Entity type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name:CONTRERAS BARRERA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HILLMONT AVE
Mailing Address - Street 2:BUILDING 340, SUITE 401
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1651
Mailing Address - Country:US
Mailing Address - Phone:805-648-9830
Mailing Address - Fax:
Practice Address - Street 1:300 HILMONT AVENUE
Practice Address - Street 2:BLDG. 340 SUITE 401
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:648-983-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant