Provider Demographics
NPI:1598892606
Name:CORNELL, BARBARA C (LMFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:C
Last Name:CORNELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 GEORGIA ST
Mailing Address - Street 2:STE 200B
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5962
Mailing Address - Country:US
Mailing Address - Phone:510-672-1091
Mailing Address - Fax:707-557-6518
Practice Address - Street 1:236 GEORGIA ST
Practice Address - Street 2:STE 200B
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5962
Practice Address - Country:US
Practice Address - Phone:707-554-9200
Practice Address - Fax:707-557-6518
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35920106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist