=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346721776
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIETA BARENBAUM LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2018
-----------------------------------------------------
Last Update Date | 01/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 E THOUSAND OAKS BLVD STE 176
-----------------------------------------------------
City | THOUSAND OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91360-8114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-422-6643
-----------------------------------------------------
Fax | 805-953-8330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 573 GALLOPING HILL RD
-----------------------------------------------------
City | SIMI VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93065-6731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-558-4020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 106912
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------