Provider Demographics
NPI:1598944662
Name:PANNONI, BARBARA J (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:PANNONI
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 W EL CAMINO REAL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2459
Mailing Address - Country:US
Mailing Address - Phone:408-373-8611
Mailing Address - Fax:
Practice Address - Street 1:1605 W EL CAMINO REAL
Practice Address - Street 2:SUITE 201
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2459
Practice Address - Country:US
Practice Address - Phone:408-373-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist