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General NPI Number Information
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NPI Number | 1891918793
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Entity Type | Individual
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Provider Name | MR. RANDY RAYMOND BARRETTO
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 500 W. HOSPITALM RD
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City | FRENCH CAMP .
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State | CA
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Zip | 95231
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Country | US
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Telephone | 209-468-6857
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Fax | 209-468-6739
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Provider Business Mailing Address
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Address Line | 6308 PINE MEADOW CIR
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City | STOCKTON
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State | CA
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Zip | 95219-2543
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Country | US
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Telephone | 209-472-7025
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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