Provider Demographics
NPI:1205592375
Name:KINGSTON, BARBARA LEE (CMT)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LEE
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:LEE
Other - Last Name:KINGSTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:GEN-E-ZEK ALTERNATIV
Mailing Address - Street 1:2908 G ST STE A
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-2106
Mailing Address - Country:US
Mailing Address - Phone:209-617-2316
Mailing Address - Fax:209-580-4219
Practice Address - Street 1:2908 G ST STE A
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-2106
Practice Address - Country:US
Practice Address - Phone:209-617-2316
Practice Address - Fax:209-580-4219
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75164225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist