Provider Demographics
NPI:1235268103
Name:STEPHAN, BARBARA BEARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:BEARD
Last Name:STEPHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HIGHWAY 1 N
Mailing Address - Street 2:P.O. BOX 8101
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93409-8101
Mailing Address - Country:US
Mailing Address - Phone:805-547-7900
Mailing Address - Fax:805-547-7504
Practice Address - Street 1:HIGHWAY 1 N
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93409-8101
Practice Address - Country:US
Practice Address - Phone:805-547-7900
Practice Address - Fax:805-547-7504
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPS 2006018103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACU265ZMedicare PIN