Most Relevant Information
Provider Data
| NPI Number: | 1003448655 |
| Provider Name: | KASSANDRA MARIE BARACEROS RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 95138709 |
Most Important Dates
| Enumeration Date: | 02/11/2020 |
| Last Updated: | 02/11/2020 |
Provider Practice Location
928 BROADWAY
SAN DIEGO
CA
921015514
Practice Location Phone/Fax
| Phone: | 6192750822 |
| Fax: | 6192755069 |
Provider Mailing Location
928 BROADWAY
SAN DIEGO
CA
921015514
Provider Mailing Phone/Fax
| Phone: | 6192750822 |
| Fax: | 6192755069 |