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General NPI Number Information
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NPI Number | 1740313592
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Entity Type | Individual
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Provider Name | SANDRA FERNANDA BARAJAS MSW
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 840 N AVENUE 66
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City | LOS ANGELES
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State | CA
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Zip | 90042-1508
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Country | US
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Telephone | 323-274-9219
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Fax |
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Provider Business Mailing Address
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Address Line | 840 N AVENUE 66
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City | LOS ANGELES
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State | CA
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Zip | 90042-1508
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Country | US
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Telephone | 626-395-7100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 80354
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 118732
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License Number State | CA
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