Individual
DR. NICK ANTHONY BARNECLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
330 N CAMPO ST, LAS CRUCES, NM 88001-3433
(575) 650-0843
(805) 419-6876
Mailing address
2301 CHAPEL DR, CAMARILLO, CA 93010-7982
(575) 650-0843
(805) 419-6876
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1108
NM
103TC1900X
Counseling Psychologist
PSY28177
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56350732
—
NM
Enumeration date
12/19/2009
Last updated
08/02/2016
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