Provider Demographics
NPI:1558652578
Name:FATTIG, BARBARA JEAN (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:FATTIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 CAPITOL AVE
Mailing Address - Street 2:#203
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5187
Mailing Address - Country:US
Mailing Address - Phone:916-287-7818
Mailing Address - Fax:
Practice Address - Street 1:1720 CAPITOL AVE
Practice Address - Street 2:STE 203
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5187
Practice Address - Country:US
Practice Address - Phone:916-287-7818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1329962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry