Provider Demographics
NPI:1366652943
Name:ZELNICK, BARBARA ANN (MFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:ZELNICK
Suffix:
Gender:F
Credentials:MFT
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 2512
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92038-2512
Mailing Address - Country:US
Mailing Address - Phone:858-337-8448
Mailing Address - Fax:858-459-2015
Practice Address - Street 1:7911 HERSCHEL AVE
Practice Address - Street 2:SUITE 411
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0075
Practice Address - Country:US
Practice Address - Phone:858-337-8448
Practice Address - Fax:858-459-2015
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43257106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43257OtherLICENSE NUMBER