Healthcare Provider Details

I. General information

NPI: 1265818058
Provider Name (Legal Business Name): KARINA BARELA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E MAIN ST
BARSTOW CA
92311
US

IV. Provider business mailing address

15400 CHOLAME RD
VICTORVILLE CA
92392-2480
US

V. Phone/Fax

Practice location:
  • Phone: 760-255-1496
  • Fax: 760-255-2542
Mailing address:
  • Phone: 760-243-5417
  • Fax: 760-255-2542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118637
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: