| NPI | 1215019393 |
|---|---|
| Other Name | JERRY FRED BARBA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY19013) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY19015) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2021-10-23 |