Healthcare Provider Details

I. General information

NPI: 1427989789
Provider Name (Legal Business Name): CHRISTOPHER BRIAN IBARRA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28078 BAXTER RD STE 540
MURRIETA CA
92563-1405
US

IV. Provider business mailing address

1303 SALMON RIVER RD
RIVERSIDE CA
92501-1516
US

V. Phone/Fax

Practice location:
  • Phone: 951-704-1066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: