Provider Demographics
NPI:1609034602
Name:MCCOY, BARBARA ANN (RN, PSYD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:RN, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PLYMOUTH CV
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-4460
Mailing Address - Country:US
Mailing Address - Phone:415-258-1727
Mailing Address - Fax:415-258-1727
Practice Address - Street 1:2150 APPIAN WAY
Practice Address - Street 2:204
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2583
Practice Address - Country:US
Practice Address - Phone:510-526-3496
Practice Address - Fax:415-258-1727
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical