Provider Demographics
NPI:1720961642
Name:IBARRA, PATRICIA LOUISE
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LOUISE
Last Name:IBARRA
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 1:3895 ASHRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1403
Mailing Address - Country:US
Mailing Address - Phone:408-841-3488
Mailing Address - Fax:
Practice Address - Street 1:3895 ASHRIDGE LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1403
Practice Address - Country:US
Practice Address - Phone:408-841-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB5461348374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula