1306505383 NPI number — JASSIEL EULALIA BARRETT LCSW

Table of content: JASSIEL EULALIA BARRETT LCSW (NPI 1306505383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306505383 NPI number — JASSIEL EULALIA BARRETT LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRETT
Provider First Name:
JASSIEL
Provider Middle Name:
EULALIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PARRA
Provider Other First Name:
JASSIEL
Provider Other Middle Name:
EULALIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ASW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306505383
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 560 BOX 369
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96376-0004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-365-1544
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIT 35123
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96376-5123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-365-1544
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/16/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCSW102784 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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