Healthcare Provider Details

I. General information

NPI: 1912814666
Provider Name (Legal Business Name): TERESA ELIZABETH BARENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18726 S WESTERN AVE
GARDENA CA
90248-3813
US

IV. Provider business mailing address

20248 BLUESTEM LN
PARKER CO
80138-7102
US

V. Phone/Fax

Practice location:
  • Phone: 310-856-0800
  • Fax: 855-568-2494
Mailing address:
  • Phone: 618-767-4453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: