Provider Demographics
NPI:1902214372
Name:BARKER, ANDREA JANE (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JANE
Last Name:BARKER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CROW CANYON COURT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1641
Mailing Address - Country:US
Mailing Address - Phone:888-531-8385
Mailing Address - Fax:925-264-1902
Practice Address - Street 1:1 CROW CANYON COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1641
Practice Address - Country:US
Practice Address - Phone:888-531-8385
Practice Address - Fax:925-264-1902
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-14-16818103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst