Provider Demographics
NPI:1750640272
Name:BARRALES, NATZAYETH EUNICE
Entity Type:Individual
Prefix:
First Name:NATZAYETH
Middle Name:EUNICE
Last Name:BARRALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZY
Other - Middle Name:EUNICE
Other - Last Name:BARRALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15200 VOSE ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2938
Mailing Address - Country:US
Mailing Address - Phone:310-351-0089
Mailing Address - Fax:
Practice Address - Street 1:6053 BRISTOL PKWY
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6601
Practice Address - Country:US
Practice Address - Phone:310-351-0089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103797106H00000X
CA69376106H00000X
CA141119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist