Provider Demographics
NPI:1558581090
Name:BARBER, EDWINA BEATRICE
Entity Type:Individual
Prefix:MISS
First Name:EDWINA
Middle Name:BEATRICE
Last Name:BARBER
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 1:5344 MARCONI AVE
Mailing Address - Street 2:APT. 111
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4385
Mailing Address - Country:US
Mailing Address - Phone:916-308-7860
Mailing Address - Fax:
Practice Address - Street 1:4801 34TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-4849
Practice Address - Country:US
Practice Address - Phone:916-737-9202
Practice Address - Fax:916-737-0262
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator