| Doctor Name: | MR. JEFFREY DARRELL BARBOA |
| NPI Number: | 1124259221 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY D. INT., RAS |
| License Number: | 00197-C |
| Business Practice Address: | 3282 Adeline Street Mental Health Division-fyc Health, Housing & Community Berkley, CA - 94704 |
| Business Phone Number: | 7022341161 |
| Business Fax Number: | 7073610899 |
| Mailing Address: | 3282 Adeline Street, Mental Health Division-fyc Health, Housing & Community BERKLEY |
| State: | CA |
| Postal Code: | 94704 |
| Phone Number: | 7022341161 |
| Fax Number: | 7073610899 |
| NPI Enumeration Date: | 08/06/2009 |
| NPI Last Update Date: | 08/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 00197-C |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |