Healthcare Provider Details

I. General information

NPI: 1972986750
Provider Name (Legal Business Name): CALEB BARCENAS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 W RAY RD STE 15-119
CHANDLER AZ
85226-1699
US

IV. Provider business mailing address

6909 W RAY RD STE 15-119
CHANDLER AZ
85226-1699
US

V. Phone/Fax

Practice location:
  • Phone: 480-613-9911
  • Fax:
Mailing address:
  • Phone: 480-613-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-005802
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY-005802
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: