Provider Demographics
NPI:1952448672
Name:BLACKMAN-BARKAN, ANNETTE (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:BLACKMAN-BARKAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:BLACKMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1411 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1854
Mailing Address - Country:US
Mailing Address - Phone:510-548-6564
Mailing Address - Fax:
Practice Address - Street 1:1026 OAK GROVE RD
Practice Address - Street 2:11
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3289
Practice Address - Country:US
Practice Address - Phone:925-646-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT26003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health