MEDICARE: MR. ROBERT WAYNE BARRON M.S., L.M.F.T.

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	MFC 45967	CA

General Provider Information

NPI Number	:	1548425051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT WAYNE BARRON M.S., L.M.F.T.

Provider Business Mailing Address
First Line	:	2635 RICHMOND CT
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-4113
Country	:	US
Telephone Number	:	951-961-4487
Fax Number	:

Provider Business Practice Location Address
First Line	:	2635 RICHMOND CT
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-4113
Country	:	US
Telephone Number	:	951-961-4487
Fax Number	:

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

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	07/23/2008

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