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NPI Code Detail

MEDICARE: JAVIER G IBARRA

MEDICARE:   JAVIER G IBARRA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorAMFT105304CA
2106H00000XMarriage & Family TherapistLMFT124318CA
3106H00000XMarriage & Family Therapist105304CA

General Provider Information

NPI Number : 1033615828
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAVIER G IBARRA
Provider Business Mailing Address
First Line : 21535 HAWTHORNE BLVD STE 102
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6626
Country : US
Telephone Number : 310-817-2177
Fax Number :
Provider Business Practice Location Address
First Line : 21535 HAWTHORNE BLVD STE 102
Second Line :
City : TORRANCE
State : CA
Zip : 90503-6626
Country : US
Telephone Number : 310-817-2177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2018
Last Update Date : 05/15/2026

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Directions to “ JAVIER G IBARRA ” Practice Location

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