Provider Demographics
NPI:1952007064
Name:BARBOSA, ALICIA ELAINE (ASW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:ELAINE
Last Name:BARBOSA
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 MIDAS ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-6408
Mailing Address - Country:US
Mailing Address - Phone:661-364-1714
Mailing Address - Fax:
Practice Address - Street 1:11907 STURGEON CREEK DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9261
Practice Address - Country:US
Practice Address - Phone:661-706-0627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW112912OtherASSOCIATE CLINICAL SOCIAL WORKER LICENSE