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NPI Code Detail

MEDICARE: DR. PRISCILLA CHINCHILLA BARAJAS PH.D

MEDICARE: DR. PRISCILLA CHINCHILLA BARAJAS PH.D
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
1103TC2200XClinical Child & Adolescent PsychologistPSY 22289CA
2103TC0700XClinical PsychologistPSY22289CA

General Provider Information

NPI Number : 1346374469
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRISCILLA CHINCHILLA BARAJAS PH.D
Provider Business Mailing Address
First Line : 13130 BURBANK BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91401-6037
Country : US
Telephone Number : 562-233-4243
Fax Number :
Provider Business Practice Location Address
First Line : 13130 BURBANK BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91401-6037
Country : US
Telephone Number : 562-233-4243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 01/10/2017

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