MEDICARE: ANNETTE BARNETT AMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	119490	CA

General Provider Information

NPI Number	:	1053008433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNETTE BARNETT AMFT

Provider Business Mailing Address
First Line	:	14583 BIG BASIN WAY STE 2B
Second Line	:
City	:	SARATOGA
State	:	CA
Zip	:	95070-6072
Country	:	US
Telephone Number	:	510-335-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	14583 BIG BASIN WAY STE 2B
Second Line	:
City	:	SARATOGA
State	:	CA
Zip	:	95070-6072
Country	:	US
Telephone Number	:	510-335-2222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	04/18/2023

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