Provider Demographics
NPI:1255481404
Name:ISRAELS, BARBARA JOAN (MA,MFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JOAN
Last Name:ISRAELS
Suffix:
Gender:F
Credentials:MA,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 TULLY RD STE C1
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-0849
Mailing Address - Country:US
Mailing Address - Phone:209-522-4164
Mailing Address - Fax:209-529-2282
Practice Address - Street 1:3300 TULLY RD STE C1
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-0849
Practice Address - Country:US
Practice Address - Phone:209-522-4164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT29567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist