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General NPI Number Information
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NPI Number | 1831075506
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Entity Type | Organization
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Legal Business Name | CRYSTAL BARRERA LICENSED CLINICAL SOCIAL WORKER, INC.
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 5170 GOLDEN FOOTHILL PKWY
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9608
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Country | US
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Telephone | 209-606-3886
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Fax | 916-282-1692
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Provider Business Mailing Address
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Address Line | PO BOX 24
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City | SHINGLE SPRINGS
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State | CA
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Zip | 95682-0024
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Country | US
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Telephone | 209-606-3886
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Fax | 916-282-1692
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Authorized Official
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Title or Position | LCSW/OWNER
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Name | CRYSTAL YVETTE BARRERA
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Credential |
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Telephone | 209-606-3886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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