Provider Demographics
NPI:1265050777
Name:BARBIC, MICHELE EILEEN (LMFT)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:EILEEN
Last Name:BARBIC
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23460 MORRILL RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-9306
Mailing Address - Country:US
Mailing Address - Phone:408-234-6392
Mailing Address - Fax:
Practice Address - Street 1:1925 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1037
Practice Address - Country:US
Practice Address - Phone:408-520-1572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98730106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist