Provider Demographics
NPI:1487999892
Name:BARRON, SERGIO
Entity type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:BARRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 SANTA MONICA BLVD
Mailing Address - Street 2:218
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1252
Mailing Address - Country:US
Mailing Address - Phone:323-465-3777
Mailing Address - Fax:323-465-3773
Practice Address - Street 1:5250 SANTA MONICA BLVD
Practice Address - Street 2:218/
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1252
Practice Address - Country:US
Practice Address - Phone:323-465-3777
Practice Address - Fax:323-465-3773
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)