Basic Information
| Provider Information | |||||||||
| NPI: | 1023211919 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | MARI | ||||||||
| MiddleName: | MICHELE | ||||||||
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| Credential: | MSW, ASW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1727 MARTIN LUTHER KING JR WAY | ||||||||
| Address2: | SUITE# 109 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946121327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108939230 | ||||||||
| FaxNumber: | 5108932074 | ||||||||
| Practice Location | |||||||||
| Address1: | 1727 MARTIN LUTHER KING JR WAY | ||||||||
| Address2: | SUITE# 109 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946121327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108939230 | ||||||||
| FaxNumber: | 5108932074 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2007 | ||||||||
| LastUpdateDate: | 03/31/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 27186 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.