Healthcare Provider Details

I. General information

NPI: 1619251881
Provider Name (Legal Business Name): DANA E BARAJAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 ALMADEN BLVD STE 600
SAN JOSE CA
95113-1605
US

IV. Provider business mailing address

3575 ARDEN WAY
SACRAMENTO CA
95864-2911
US

V. Phone/Fax

Practice location:
  • Phone: 213-248-1819
  • Fax: 213-895-6266
Mailing address:
  • Phone: 213-248-1819
  • Fax: 213-895-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number82551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: