Healthcare Provider Details

I. General information

NPI: 1356532790
Provider Name (Legal Business Name): BEATRIZ BARAJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 W VICTORIA ST
COMPTON CA
90220-5804
US

IV. Provider business mailing address

12705 NORWALK BLVD APT.20
NORWALK CA
90650-3165
US

V. Phone/Fax

Practice location:
  • Phone: 562-219-1722
  • Fax:
Mailing address:
  • Phone: 562-219-1722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: