Healthcare Provider Details

I. General information

NPI: 1982808192
Provider Name (Legal Business Name): BARBARA JEANETTE RANKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5012 S LA BREA AVE STE 3
LOS ANGELES CA
90056-1863
US

IV. Provider business mailing address

5012 S LA BREA AVE STE 3
LOS ANGELES CA
90056-1863
US

V. Phone/Fax

Practice location:
  • Phone: 323-298-3050
  • Fax: 323-298-3083
Mailing address:
  • Phone: 323-298-3050
  • Fax: 323-298-3083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: