Provider Demographics
NPI:1790031946
Name:BARBER, LAUREL ANNMARIE (RN, NP)
Entity Type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:ANNMARIE
Last Name:BARBER
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1900 FRUITVALE AVE
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2464
Mailing Address - Country:US
Mailing Address - Phone:510-532-1930
Mailing Address - Fax:510-532-0963
Practice Address - Street 1:1000 BROADWAY
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4099
Practice Address - Country:US
Practice Address - Phone:510-532-1930
Practice Address - Fax:510-932-0065
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA538891163W00000X
CA19262363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health