Provider Demographics
NPI:1023223096
Name:MCCARROLL, BARBARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:MCCARROLL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1647
Mailing Address - Street 2:
Mailing Address - City:ROSS
Mailing Address - State:CA
Mailing Address - Zip Code:94957-1647
Mailing Address - Country:US
Mailing Address - Phone:415-457-3392
Mailing Address - Fax:
Practice Address - Street 1:905 SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:KENTFIELD
Practice Address - State:CA
Practice Address - Zip Code:94904-1588
Practice Address - Country:US
Practice Address - Phone:415-457-3392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16378103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical