Provider Demographics
NPI:1427392679
Name:PEMBERTON, BARBARA (BCBA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:PEMBERTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 LA MESA DR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3815
Mailing Address - Country:US
Mailing Address - Phone:831-754-1603
Mailing Address - Fax:831-272-3080
Practice Address - Street 1:915 BLANCO CIR # C
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4450
Practice Address - Country:US
Practice Address - Phone:831-998-8475
Practice Address - Fax:831-272-3080
Is Sole Proprietor?:No
Enumeration Date:2012-11-11
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-3636103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst