Provider Demographics
NPI:1609028695
Name:WEAVER, BARBARA LYNN
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:WEAVER
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 1:9370 ECKERMAN RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5911
Mailing Address - Country:US
Mailing Address - Phone:916-532-1757
Mailing Address - Fax:
Practice Address - Street 1:9370 ECKERMAN RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-5911
Practice Address - Country:US
Practice Address - Phone:916-532-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)