Provider Demographics
NPI:1104838341
Name:COLEY, BARBARA (MHRS)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:COLEY
Suffix:
Gender:F
Credentials:MHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 MARY ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3507
Mailing Address - Country:US
Mailing Address - Phone:415-847-8689
Mailing Address - Fax:415-457-9677
Practice Address - Street 1:29 MARY ST
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3507
Practice Address - Country:US
Practice Address - Phone:415-721-2232
Practice Address - Fax:415-457-9677
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator