Provider Demographics
NPI:1922634799
Name:BARRIOS, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:BARRIOS
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 1:615 W CIVIC CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4006
Mailing Address - Country:US
Mailing Address - Phone:714-795-3444
Mailing Address - Fax:714-795-3445
Practice Address - Street 1:615 W CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4006
Practice Address - Country:US
Practice Address - Phone:714-795-3444
Practice Address - Fax:714-795-3445
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker