Provider Demographics
NPI:1447308820
Name:BARRERA, ADRIANA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:MARIA
Last Name:BARRERA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 MALCOLM AVE
Mailing Address - Street 2:APT#203
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23451 MADISON ST
Practice Address - Street 2:SUITE 350
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4763
Practice Address - Country:US
Practice Address - Phone:310-373-2829
Practice Address - Fax:310-373-2971
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD50438Medicaid