Provider Demographics
NPI:1114123536
Name:NEAL, BARBARA DENISE (MA)
Entity Type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:DENISE
Last Name:NEAL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:DENISE
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:600 N ARROWHEAD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1148
Mailing Address - Country:US
Mailing Address - Phone:909-522-4656
Mailing Address - Fax:909-763-5525
Practice Address - Street 1:600 N ARROWHEAD AVE STE 300
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1148
Practice Address - Country:US
Practice Address - Phone:909-522-4656
Practice Address - Fax:909-763-5525
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101600106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1760651178Medicaid