=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184746265
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA SWAN WALKER M.S., M.F.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 841 SAN BRUNO AVE W SUITE 2
-----------------------------------------------------
City | SAN BRUNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94066-3443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-219-6597
-----------------------------------------------------
Fax | 650-355-8609
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 SURF ST
-----------------------------------------------------
City | PACIFICA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94044-2233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-738-8542
-----------------------------------------------------
Fax | 650-355-8609
-----------------------------------------------------
=====================================================
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 | MFT 33837
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------