Healthcare Provider Details

I. General information

NPI: 1902156664
Provider Name (Legal Business Name): JAYNANN BARCKLAY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 07/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10333 EL CAMINO REAL
ATASCADERO CA
93422-5808
US

IV. Provider business mailing address

1600 9TH ST ROOM 150 FISCAL ALLOCATIONS AND ESTIMATES UNIT
SACRAMENTO CA
95814-6414
US

V. Phone/Fax

Practice location:
  • Phone: 805-468-2000
  • Fax: 805-468-6011
Mailing address:
  • Phone: 916-651-9475
  • Fax: 916-651-8908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: