Provider Demographics
NPI:1992436711
Name:BARCELONA, FERNANDO (LMFT)
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:BARCELONA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 E SAN LUCAS RD
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-8185
Mailing Address - Country:US
Mailing Address - Phone:310-699-8857
Mailing Address - Fax:
Practice Address - Street 1:444 N LARCHMONT BLVD STE 109
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3030
Practice Address - Country:US
Practice Address - Phone:213-986-5752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145274106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist