Provider Demographics
NPI:1205162104
Name:BARBOUR, CAMILA MENDEZ
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:MENDEZ
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 EUCLID AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-3116
Mailing Address - Country:US
Mailing Address - Phone:619-218-3785
Mailing Address - Fax:
Practice Address - Street 1:205 MASON CIR
Practice Address - Street 2:SUITE A
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1203
Practice Address - Country:US
Practice Address - Phone:925-521-1270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool