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General NPI Number Information
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NPI Number | 1871324046
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Entity Type | Organization
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Legal Business Name | FIVE ACRES
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 867 N FAIR OAKS AVE
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City | PASADENA
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State | CA
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Zip | 91103-3050
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Country | US
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Telephone | 626-798-6793
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Fax |
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Provider Business Mailing Address
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Address Line | 760 MOUNTAIN VIEW ST
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City | ALTADENA
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State | CA
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Zip | 91001-4996
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Country | US
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Telephone | 626-798-6793
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | JACQUELINE BARRAZA
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Credential | AMFT
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Telephone | 323-594-4654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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