Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 16761 | CA |
NPI | 1427117670 |
---|---|
Provider Name | Dr. Barbara Lynn Sprayregen |
First Address | Long Beach, CA 90804-3270 |
Second Address | Huntington Beach, CA 92647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
173833 | MHN PIN (01) | |
5803536 | AETNA PIN (01) |