Provider Demographics
NPI:1538779830
Name:BARRAGAN, ELIZABETH GUADALUPE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GUADALUPE
Last Name:BARRAGAN
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 1:650 UNIVERSITY AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6726
Mailing Address - Country:US
Mailing Address - Phone:916-646-2471
Mailing Address - Fax:916-646-2472
Practice Address - Street 1:650 UNIVERSITY AVE STE 108
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6726
Practice Address - Country:US
Practice Address - Phone:916-646-2471
Practice Address - Fax:916-646-2472
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8586237700000X
CAAU3577237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist