Provider Demographics
NPI:1184746265
Name:WALKER, BARBARA SWAN (MS, MFT)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:SWAN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SURF ST
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2233
Mailing Address - Country:US
Mailing Address - Phone:650-738-8542
Mailing Address - Fax:650-355-8609
Practice Address - Street 1:841 SAN BRUNO AVE W
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3443
Practice Address - Country:US
Practice Address - Phone:650-219-6597
Practice Address - Fax:650-355-8609
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 33837106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist