Provider Demographics
NPI:1225139850
Name:FERNANDEZ-BARILLAS, HECTOR J (PHD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:J
Last Name:FERNANDEZ-BARILLAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N TUCSON BLVD STE 21
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3407
Mailing Address - Country:US
Mailing Address - Phone:520-325-6633
Mailing Address - Fax:520-325-6677
Practice Address - Street 1:2102 N COUNTRY CLUB RD
Practice Address - Street 2:SUITE 4
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2831
Practice Address - Country:US
Practice Address - Phone:520-325-6633
Practice Address - Fax:520-325-6644
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1320103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ122771Medicaid
AZ122771Medicaid