Provider Demographics
NPI:1710516240
Name:BARON, VINCENT PAUL LACSON
Entity Type:Individual
Prefix:MR
First Name:VINCENT PAUL
Middle Name:LACSON
Last Name:BARON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 YOUNG ST APT 606
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1933
Mailing Address - Country:US
Mailing Address - Phone:808-725-9405
Mailing Address - Fax:
Practice Address - Street 1:1125 YOUNG ST APT 606
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1933
Practice Address - Country:US
Practice Address - Phone:808-725-9405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty