Provider Demographics
NPI:1841306479
Name:CAMPBELL, BARBARA LUPE (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LUPE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-6838
Mailing Address - Country:US
Mailing Address - Phone:415-775-1400
Mailing Address - Fax:415-775-5784
Practice Address - Street 1:242 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6838
Practice Address - Country:US
Practice Address - Phone:415-775-1400
Practice Address - Fax:415-775-5784
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6966103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical