Provider Demographics
NPI:1821515487
Name:BARRIOS, RENE ANTONIO
Entity Type:Individual
Prefix:MR
First Name:RENE
Middle Name:ANTONIO
Last Name:BARRIOS
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 1:5151 N PALM AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2221
Mailing Address - Country:US
Mailing Address - Phone:559-236-5251
Mailing Address - Fax:559-238-0755
Practice Address - Street 1:5151 N PALM AVE STE 200
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2221
Practice Address - Country:US
Practice Address - Phone:559-236-5251
Practice Address - Fax:559-238-0755
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101129106H00000X
CA121218106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist