Provider Demographics
NPI:1477606077
Name:BARCENAS, OLIVIA SUSANA
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:SUSANA
Last Name:BARCENAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 BRINWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-3087
Mailing Address - Country:US
Mailing Address - Phone:925-705-5995
Mailing Address - Fax:
Practice Address - Street 1:620 BRINWOOD WAY
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-3087
Practice Address - Country:US
Practice Address - Phone:925-705-5995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46178106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist