Provider Demographics
NPI:1275769861
Name:BARRAZA REYES, NUBIA
Entity Type:Individual
Prefix:
First Name:NUBIA
Middle Name:
Last Name:BARRAZA REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NUBIA
Other - Middle Name:IBETH
Other - Last Name:BARRAZA PRIETO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:301 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-6211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6211
Practice Address - Country:US
Practice Address - Phone:209-381-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF82603106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF82603OtherMARRIAGE AND FAMILY THERAPIST INTERN