Provider Demographics
NPI:1700952629
Name:BINGHAM, BARBARA LYNN (MFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9851 HORN RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1993
Mailing Address - Country:US
Mailing Address - Phone:916-366-0161
Mailing Address - Fax:916-366-0149
Practice Address - Street 1:9851 HORN RD
Practice Address - Street 2:SUITE 180
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1993
Practice Address - Country:US
Practice Address - Phone:916-366-0161
Practice Address - Fax:916-366-0149
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30306106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist