Provider Demographics
NPI:1063501690
Name:BARNETT, MARCIA MAE (LCSW MFT MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:MAE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LCSW MFT MSW
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:MAE
Other - Last Name:ZUADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:628 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533
Mailing Address - Country:US
Mailing Address - Phone:707-426-0763
Mailing Address - Fax:707-426-0951
Practice Address - Street 1:628 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:707-426-0763
Practice Address - Fax:707-426-0951
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS35721041C0700X
CAMFC5937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist