Provider Demographics
NPI:1710305859
Name:EASON, BARBARA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:EASON
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 1:100 ROWLAND WAY
Mailing Address - Street 2:#125
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-5011
Mailing Address - Country:US
Mailing Address - Phone:415-209-2444
Mailing Address - Fax:
Practice Address - Street 1:100 ROWLAND WAY
Practice Address - Street 2:#125
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5011
Practice Address - Country:US
Practice Address - Phone:415-209-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-05
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist