Provider Demographics
NPI:1720009319
Name:HASS, BARBARA (MSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:HASS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:BOMZE-HASS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2320 CASCADE
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1039
Mailing Address - Country:US
Mailing Address - Phone:714-368-3306
Mailing Address - Fax:714-832-2229
Practice Address - Street 1:2320 CASCADE
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1039
Practice Address - Country:US
Practice Address - Phone:714-368-3306
Practice Address - Fax:714-832-2229
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 103351041C0700X
CAMFC 18751106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW10335Medicare PIN