Provider Demographics
NPI:1376095661
Name:BARNES, BRIANA MISHELL (ATC)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:MISHELL
Last Name:BARNES
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 OXSEN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-8412
Mailing Address - Country:US
Mailing Address - Phone:925-895-7875
Mailing Address - Fax:
Practice Address - Street 1:1536 OXSEN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8412
Practice Address - Country:US
Practice Address - Phone:925-895-7875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3149352081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine