MEDICARE: MARIA LAURA BARRIO MASTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	AMFT108871	CA

General Provider Information

NPI Number	:	1316419823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA LAURA BARRIO MASTER

Provider Business Mailing Address
First Line	:	5550 FOREST COVE LN
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-4047
Country	:	US
Telephone Number	:	818-575-0946
Fax Number	:

Provider Business Practice Location Address
First Line	:	8399 TOPANGA CANYON BLVD STE 303
Second Line	:
City	:	CANOGA PARK
State	:	CA
Zip	:	91304-2354
Country	:	US
Telephone Number	:	818-898-0223
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2018
Last Update Date	:	02/01/2019

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