Provider Demographics
NPI:1366572836
Name:BARRON, ELAINE ADOLF (LCSW)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:ADOLF
Last Name:BARRON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N RAMONA BLVD
Mailing Address - Street 2:STE. 2
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-2567
Mailing Address - Country:US
Mailing Address - Phone:951-487-2674
Mailing Address - Fax:951-487-2679
Practice Address - Street 1:950 N RAMONA BLVD
Practice Address - Street 2:STE. 2
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-2567
Practice Address - Country:US
Practice Address - Phone:951-487-2674
Practice Address - Fax:951-487-2679
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 121741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical