Provider Demographics
NPI:1417067232
Name:BARNHART, MARIA DIMITRIOV (PHD)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:DIMITRIOV
Last Name:BARNHART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 LONE TREE WAY
Mailing Address - Street 2:SUITE A1
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6000
Mailing Address - Country:US
Mailing Address - Phone:925-756-1334
Mailing Address - Fax:925-756-1337
Practice Address - Street 1:3725 LONE TREE WAY
Practice Address - Street 2:SUITE A1
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6000
Practice Address - Country:US
Practice Address - Phone:925-756-1334
Practice Address - Fax:925-756-1337
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14951103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
00PL14951Medicare ID - Type Unspecified