Provider Demographics
NPI:1497811640
Name:PLATIN, BARBARA SUSAN (MFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUSAN
Last Name:PLATIN
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 1:33 ESTRELLA PL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-2332
Mailing Address - Country:US
Mailing Address - Phone:925-837-1965
Mailing Address - Fax:925-362-9040
Practice Address - Street 1:425 OAK ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-1388
Practice Address - Country:US
Practice Address - Phone:925-355-2515
Practice Address - Fax:925-362-9040
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist