Provider Demographics
NPI:1700101516
Name:MAYNARD, BARBARA J (LMFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:MAYNARD
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:PO BOX 20015
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94620-0015
Mailing Address - Country:US
Mailing Address - Phone:925-788-9041
Mailing Address - Fax:510-655-3706
Practice Address - Street 1:1844 SAN MIGUEL AVE
Practice Address - Street 2:#317
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4962
Practice Address - Country:US
Practice Address - Phone:925-788-9041
Practice Address - Fax:510-655-3706
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28588106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist