Provider Demographics
NPI:1548993405
Name:BARROSO, TATYANA NICOLE (AMFT)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:NICOLE
Last Name:BARROSO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 ORANGE DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1618
Mailing Address - Country:US
Mailing Address - Phone:805-236-8391
Mailing Address - Fax:
Practice Address - Street 1:3585 MAPLE ST STE 265
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-9135
Practice Address - Country:US
Practice Address - Phone:970-309-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist