Basic Information
| Provider Information | |||||||||
| NPI: | 1023675758 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARBEAU | ||||||||
| FirstName: | EUGENIE | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11985 POMERING RD | ||||||||
| Address2: | |||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902422115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626197735 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12440 FIRESTONE BLVD STE 316 | ||||||||
| Address2: | |||||||||
| City: | NORWALK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906509319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628643722 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2019 | ||||||||
| LastUpdateDate: | 05/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 11620 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | 4358 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 4358 | CA | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.