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Miguel Ibarra
Mental Health Counselor in Petaluma, California
NPI 1346883840

Miguel Ibarra is a Mental Health Counselor based in Santa Rosa, CA and is specialized in Mental Health. Miguel Ibarra practices in Petaluma, CA. The NPI Number for Miguel Ibarra is 1346883840 and holds a License No. (California).

The current practice location address for Miguel Ibarra is 5350 Old Redwood Highway, Petaluma, CA and can be reached out via phone at 707-565-4993.

Location: 5350 Old Redwood Highway, Petaluma, CA, 95401-5974
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346883840
Provider Name
Miguel Ibarra
Credential
Provider Entity Type
Individual
Gender
Male
Address
5350 Old Redwood Highway, Petaluma, CA, 95401-5974
Phone Number
707-565-4993
Fax Number
Provider Enumeration Date
10/28/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
12179547 01 CA KAISER
institution
Provider Business Practice Location Address Details
Address
5350 Old Redwood Highway
City
Petaluma
State
California
Zip
94954
Phone Number
707-565-4993
Fax Number
person
Provider Business Mailing Address Details
Address
5350 Old Redwood Highway
City
Petaluma
State
California
Zip
94954
Phone Number
707-565-4993
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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