Healthcare Provider Details

I. General information

NPI: 1508110149
Provider Name (Legal Business Name): MRS. EMMA ROSE BARON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA CELINA DUARTE LCSW

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 WAGON CREEK CIR
SAN JACINTO CA
92582-2225
US

IV. Provider business mailing address

1544 WAGON CREEK CIR
SAN JACINTO CA
92582-2225
US

V. Phone/Fax

Practice location:
  • Phone: 951-669-8289
  • Fax: 951-223-7878
Mailing address:
  • Phone: 951-669-8289
  • Fax: 951-223-7878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW83059
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: