Gerald Fred Barba, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY19013 Issued in CA

Practice address

9449 E. Imperial Highway
Suite 206
Downey, CA 90242

Phone

(562) 657-2055

Fax

(562) 429-2559

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jerry Fred Barba Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Bellflower, CA
  • NPI 1043242555
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634947200000",
    "number": "1215019393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 E. IMPERIAL HIGHWAY",
            "address_2": "SUITE 206",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "562-657-2055",
            "fax_number": "562-429-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 E. IMPERIAL HIGHWAY",
            "address_2": "SUITE 206",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "562-657-2055",
            "fax_number": "562-429-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBA",
        "first_name": "GERALD",
        "middle_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-10-23",
        "certification_date": "2021-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19013",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19015",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "BARBA",
            "middle_name": "FRED",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cynthia Banuelos
• Ingrid Stephanie Banuelos
• Marlene Guadalupe Banuelos
• Brenda Barajas
• Maritza Barajas
• Jessica Ann Barba, MSW
• Cristionne Barbarin, LCSW
• Shuree Barber
• Alexandra Barbosa
• Margarita Barboza

• Clinical Psychologist in Downey, CA
• Providers in Downey, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.