Healthcare Provider Details

I. General information

NPI: 1326192840
Provider Name (Legal Business Name): STEVEN LEE BARRON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 HEMLOCK AVE
MORRO BAY CA
93442-1431
US

IV. Provider business mailing address

PO BOX 2143
ATASCADERO CA
93423-2143
US

V. Phone/Fax

Practice location:
  • Phone: 805-772-5186
  • Fax:
Mailing address:
  • Phone: 805-772-5186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY19747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: