Provider Demographics
NPI:1972784015
Name:BARRIENTOS, LISA (PSYD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:BARRIENTOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16010 N 28TH AVE
Mailing Address - Street 2:TRIWEST CORPORATE BEHAVIORAL HEALTH
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16010 N 28TH AVE
Practice Address - Street 2:TRIWEST CORPORATE BEHAVIORAL HEALTH
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-4049
Practice Address - Country:US
Practice Address - Phone:888-874-9378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4036103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical