=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184649451
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM THOMAS BARKER ED.D. MFT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1451 DANVILLE BLVD STE 203
-----------------------------------------------------
City | ALAMO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94507-1941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-938-3261
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1491 BEERS HUMBIRD DR
-----------------------------------------------------
City | SAGLE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83860-8599
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-938-3261
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFT021168
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | LMFT 3813
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------