Provider Demographics
NPI:1265419170
Name:BARRERA, RUTH ANNE (RN; NP)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANNE
Last Name:BARRERA
Suffix:
Gender:F
Credentials:RN; NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3812 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4301
Mailing Address - Country:US
Mailing Address - Phone:559-495-3120
Mailing Address - Fax:559-495-3134
Practice Address - Street 1:2944 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1405
Practice Address - Country:US
Practice Address - Phone:559-497-7900
Practice Address - Fax:559-497-6019
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA358706163W00000X
CA8722363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA358706OtherREGISTERED NURSE
CA8722OtherNURSE PRACTITIONER FURN