Provider Demographics
NPI:1184856718
Name:BAROS, LEONARD PAUL SR (CATC)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:PAUL
Last Name:BAROS
Suffix:SR
Gender:M
Credentials:CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2657 WEXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5579
Mailing Address - Country:US
Mailing Address - Phone:650-583-7429
Mailing Address - Fax:
Practice Address - Street 1:2657 WEXFORD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5579
Practice Address - Country:US
Practice Address - Phone:650-583-7429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-16
Last Update Date:2009-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2043-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)