Provider Demographics
NPI:1689866048
Name:BARAJAS, CECILIA R (MS)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:R
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:CECILIA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:11060 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3047
Mailing Address - Country:US
Mailing Address - Phone:951-358-6726
Mailing Address - Fax:951-358-7688
Practice Address - Street 1:11060 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505
Practice Address - Country:US
Practice Address - Phone:951-358-6415
Practice Address - Fax:951-358-7688
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC50331106H00000X
CA54309106H00000X
CALMFT50331106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist