Mary Baracco, CNM NP
Individual provider Active NPI Advanced Practice Midwife · Weaverville, CA
NPI 1255429528 · NPPES record last updated Sep 8, 2016
Key facts
- NPI
- 1255429528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- 1211 (CA)
- Practice address
- 31 Easter Ave
Weaverville, CA 96093-0000 - Phone
- (530) 623-4186
- Fax
- (530) 623-4397
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Nurse Midwife, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 490245 | CA | MD | Registered Nurse |
| 1211 | CA | MD | Occupational Therapy Assistant |
| 8853 | CA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 490245 | CA | |
| Nurse Practitioner | 363L00000X | 8853 | CA | |
| Advanced Practice Midwife | 367A00000X | 1211 | CA | Yes |
Addresses
Primary practice location
31 Easter Ave
Weaverville, CA 96093-0000
Mailing address
PO Box 154
201 Steelhead Circle
Lewiston, CA 96052-0154
Phone (530) 778-3354
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0081501 | Other | CA | MEDICAL |
| GR0081500 | Medicaid | CA |
Other providers in Weaverville, CA
- Jiraporn Dow Angspatt
- Nancy Sickle Antoon
- Julia Lynn Ashton-Boyd
- Carolyn Atterberry
- Melissa Anne Daluz Avila
- Katie Ziser Barone
- Tammerab Baudizzon
- Steven Bayless
- April Asher Beard
- Dawn B Bennett
All providers in Weaverville, CA · Advanced Practice Midwife in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.