Healthcare Provider Details

I. General information

NPI: 1720396609
Provider Name (Legal Business Name): ANDREA ELLEN BARNETT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 S 3RD AVE
OAKDALE CA
95361-3935
US

IV. Provider business mailing address

168 S 3RD AVE
OAKDALE CA
95361-3935
US

V. Phone/Fax

Practice location:
  • Phone: 209-848-4884
  • Fax:
Mailing address:
  • Phone: 209-848-4884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number75338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: