Provider Demographics
NPI:1568514990
Name:TODD, BARBARA MARIE (PHD, MSCP)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:MARIE
Last Name:TODD
Suffix:
Gender:F
Credentials:PHD, MSCP
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:MARIE
Other - Last Name:TODD-NELSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, MSCP
Mailing Address - Street 1:4125 BANGS AVE
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS, KAISER PERMANENTE
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8713
Mailing Address - Country:US
Mailing Address - Phone:209-557-1643
Mailing Address - Fax:209-557-1760
Practice Address - Street 1:4125 BANGS AVE
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS, KAISER PERMANENTE
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8713
Practice Address - Country:US
Practice Address - Phone:209-557-1643
Practice Address - Fax:209-557-1760
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16379103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical