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General NPI Number Information
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NPI Number | 1699960328
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Entity Type | Individual
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Provider Name | WENDY BARKSDALE ASW
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Gender | Female
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 1735 ENTERPRISE DR 205D
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City | FAIRFIELD
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State | CA
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Zip | 94533-6822
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Country | US
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Telephone | 707-422-0464
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Fax | 707-422-0465
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Provider Business Mailing Address
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Address Line | 274E SUNSET AVE. # 167
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City | SUISUN CITY
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State | CA
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Zip | 94585
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Country | US
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Telephone | 707-422-0464
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Fax | 707-422-0465
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW46744
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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