Provider Demographics
NPI:1700172160
Name:BARAJAS, HECTOR RENE
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:RENE
Last Name:BARAJAS
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 1:19443 OPAL LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3244
Mailing Address - Country:US
Mailing Address - Phone:805-469-9002
Mailing Address - Fax:
Practice Address - Street 1:19443 OPAL LN
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3244
Practice Address - Country:US
Practice Address - Phone:805-469-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT92775106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist