Provider Demographics
NPI:1841310893
Name:BARANOFF, EUGENIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:EUGENIE
Middle Name:
Last Name:BARANOFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:EUGENIE
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:14277 ROAD 28
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-5715
Mailing Address - Country:US
Mailing Address - Phone:559-675-7850
Mailing Address - Fax:559-675-7758
Practice Address - Street 1:14277 ROAD 28
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-5715
Practice Address - Country:US
Practice Address - Phone:559-675-7850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS126481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR22003Medicare UPIN