Healthcare Provider Details

I. General information

NPI: 1952369415
Provider Name (Legal Business Name): BARBARA SPALDING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 E. ELDER STREET STE A
FALLBROOK CA
92028-5001
US

IV. Provider business mailing address

565 RANCHO CAMINO
FALLBROOK CA
92028-9093
US

V. Phone/Fax

Practice location:
  • Phone: 760-293-7123
  • Fax: 760-728-7123
Mailing address:
  • Phone: 760-293-7123
  • Fax: 760-728-7123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC11173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: