Provider Demographics
NPI:1851604987
Name:BLASDEL, BARBARA ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ELIZABETH
Last Name:BLASDEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 SACRAMENTO ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1896
Mailing Address - Country:US
Mailing Address - Phone:415-567-5553
Mailing Address - Fax:
Practice Address - Street 1:3530 SACRAMENTO ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1896
Practice Address - Country:US
Practice Address - Phone:415-567-5553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-18
Last Update Date:2010-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10434103TC0700X, 103TP0814X
CAMFT9624106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR23621Medicare UPIN