Basic Information
Provider Information
NPI: 1760966360
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRIOS
FirstName: YANET
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DEL PINO
OtherFirstName: YANET
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 21600 OXNARD ST STE 1800
Address2:  
City: WOODLAND HILLS
State: CA
PostalCode: 913677807
CountryCode: US
TelephoneNumber: 8183452345
FaxNumber: 0000000000
Practice Location
Address1: 2500 W HIGGINS RD STE 870
Address2:  
City: HOFFMAN ESTATES
State: IL
PostalCode: 601697266
CountryCode: US
TelephoneNumber: 8476489204
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/19/2018
LastUpdateDate: 09/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000X  Y    

No ID Information.


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