Provider Demographics
NPI:1700033453
Name:BARLO, IVANA (AODC)
Entity Type:Individual
Prefix:MISS
First Name:IVANA
Middle Name:
Last Name:BARLO
Suffix:
Gender:F
Credentials:AODC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 4TH AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-6137
Mailing Address - Country:US
Mailing Address - Phone:323-419-1442
Mailing Address - Fax:
Practice Address - Street 1:6850 VAN NUYS BLVD
Practice Address - Street 2:125
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4640
Practice Address - Country:US
Practice Address - Phone:818-908-1740
Practice Address - Fax:818-908-3336
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)