Healthcare Provider Details

I. General information

NPI: 1245385376
Provider Name (Legal Business Name): RACHAEL ESPERANZA BARRETO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 N WHITE RD CROSSROADS VILLAGE/MOMENTUM FOR MENTAL HEALTH
SAN JOSE CA
95127
US

IV. Provider business mailing address

2001 THE ALAMEDA ALLIANCE FOR COMMUNITY CARE
SAN JOSE CA
95126-1136
US

V. Phone/Fax

Practice location:
  • Phone: 408-254-6848
  • Fax: 408-937-5394
Mailing address:
  • Phone: 408-261-7777
  • Fax: 408-254-9960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number65820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: