Provider Demographics
NPI:1174867063
Name:BARB, RICHELLE MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICHELLE
Middle Name:MARIE
Last Name:BARB
Suffix:
Gender:F
Credentials:PSYD
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 8500
Mailing Address - Street 2:24863 W JAYNE AVE
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210-8500
Mailing Address - Country:US
Mailing Address - Phone:559-935-4900
Mailing Address - Fax:
Practice Address - Street 1:24863 W JAYNE AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9502
Practice Address - Country:US
Practice Address - Phone:559-935-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22120103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic