| Ms Vanessa Jeanne De Barros I, LAADC, CATC IV | |
|
17921 S Avery Pl, Gardena, CA 90248-3710 | |
| (424) 340-9267 | |
| (424) 340-2368 |
| Full Name | Ms Vanessa Jeanne De Barros I |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 17921 S Avery Pl, Gardena, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982277653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LR10420324 (California) | Primary |
| Entity Name | Neuro Fitness Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659072106 PECOS PAC ID: 8325404585 Enrollment ID: O20230614002253 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Vanessa Jeanne De Barros I, LAADC, CATC IV 17921 S Avery Pl, Gardena, CA 90248-3710 Ph: (424) 340-9267 | Ms Vanessa Jeanne De Barros I, LAADC, CATC IV 17921 S Avery Pl, Gardena, CA 90248-3710 Ph: (424) 340-9267 |
Jessie Jr. N/a Galloway, N/A Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 | |
Ronald Fernandes, Counselor Medicare: Not Enrolled in Medicare Practice Location: 108 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 | |
Dr. Natasha Montez Shaw-clark, Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 W Victoria St, Gardena, CA 90248 Phone: 310-715-2020 Fax: 310-715-6600 | |
Mr. Jeneal Edward Durr, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1214 W 146th St, Gardena, CA 90247 Phone: 310-774-7309 | |
Ms. Stacy N Menziess, CASE MANAGER Counselor Medicare: Not Enrolled in Medicare Practice Location: 555 W Redondo Beach Blvd, Suite 204, Gardena, CA 90248 Phone: 310-352-6422 Fax: 310-352-6480 | |
Ms. Celia Marie Aragon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 15519 Crenshaw Blvd, Gardena, CA 90249 Phone: 310-679-9126 Fax: 310-679-2920 | |
Joessa Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 879 W 190th St Ste 350, Gardena, CA 90248 Phone: 310-323-6887 |