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NPI Code Detail

MEDICARE: DR. MIGUEL KELLER HIDALGO-BARNES PSY.D.

MEDICARE: DR. MIGUEL KELLER HIDALGO-BARNES PSY.D.
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
1103TC0700XClinical PsychologistPSY24974CA

General Provider Information

NPI Number : 1669656393
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIGUEL KELLER HIDALGO-BARNES PSY.D.
Provider Business Mailing Address
First Line : 3095 RICHMOND PKWY
Second Line : STE 201
City : RICHMOND
State : CA
Zip : 94806-5878
Country : US
Telephone Number : 510-596-8125
Fax Number :
Provider Business Practice Location Address
First Line : 3095 RICHMOND PKWY
Second Line : STE 201
City : RICHMOND
State : CA
Zip : 94806-5878
Country : US
Telephone Number : 510-596-8125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2007
Last Update Date : 05/19/2025

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