Provider Demographics
NPI:1740508266
Name:CAMPBELL, BARBARA RUTH (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:RUTH
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LCSW
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 22210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-2210
Mailing Address - Country:US
Mailing Address - Phone:510-535-6448
Mailing Address - Fax:
Practice Address - Street 1:1390 66TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-3506
Practice Address - Country:US
Practice Address - Phone:510-639-1981
Practice Address - Fax:510-535-4225
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS257221041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical