Provider Demographics
NPI:1184649451
Name:BARKER, WILLIAM THOMAS (EDD MFT)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:BARKER
Suffix:
Gender:M
Credentials:EDD MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 BEERS HUMBIRD DR
Mailing Address - Street 2:
Mailing Address - City:SAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83860-8599
Mailing Address - Country:US
Mailing Address - Phone:925-938-3261
Mailing Address - Fax:
Practice Address - Street 1:1451 DANVILLE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1941
Practice Address - Country:US
Practice Address - Phone:925-938-3261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT021168106H00000X
IDLMFT 3813106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist