Carlene Barbosa

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95017924 Issued in CA

Practice address

11588 Yorba Ave
Chino, CA 91710-1765

Phone

(949) 813-5776

NPI assigned

Aug 23, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: carlene.barbosa@398008301912068.direct.elationemr.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1073280632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8850 VALLEY VIEW ST",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11588 YORBA AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101765",
            "telephone_number": "949-813-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOSA",
        "first_name": "CARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017924",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerim Bangou
• Nancy Banh, OD
• Mara Jasmin Banuelos, FNP
• Sandra Banuelos
• Barbara Allen Legacy Foundation
• Jacqueline Adriana Barbosa, PA-C
• Veronica Scheele Baron-Vartian, LCSW, PPSC
• Ronni Barrios
• Barsoum Dental Corp
• Isabelle Fahmi Barsoum Sr., AMFT

• Nurse Practitioner in Chino, CA
• Providers in Chino, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.