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NPI Code Detail

MEDICARE: ERIBERTO DEALBA

MEDICARE: ERIBERTO DEALBA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1811173891
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIBERTO DEALBA
Provider Business Mailing Address
First Line : 646 NORTH H ST.
Second Line :
City : LOMPOC
State : CA
Zip : 93436
Country : US
Telephone Number : 805-865-1940
Fax Number :
Provider Business Practice Location Address
First Line : 646 N H ST
Second Line :
City : LOMPOC
State : CA
Zip : 93436-4519
Country : US
Telephone Number : 805-865-1940
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2008
Last Update Date : 01/21/2008

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Directions to “ ERIBERTO DEALBA ” Practice Location

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