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General NPI Number Information
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NPI Number | 1437455425
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Entity Type | Organization
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Legal Business Name | DR. BARRAZA-REYES, PHD, A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 11/24/2014
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Provider Practice Location Address
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Address Line | 121 W WHITTIER BLVD SUITE 23
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City | LA HABRA
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State | CA
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Zip | 90631-3893
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Country | US
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Telephone | 562-697-9796
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Fax | 562-697-9787
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Provider Business Mailing Address
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Address Line | 121 W WHITTIER BLVD SUITE 23
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City | LA HABRA
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State | CA
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Zip | 90631-3893
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Country | US
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Telephone | 562-697-9796
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Fax | 562-697-9787
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. YVETTE BARRAZA-REYES
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Credential | PHD
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Telephone | 562-697-9796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY20336
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY20336
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License Number State | CA
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