MEDICARE: MACEO BARBER

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	IMF39667	CA

General Provider Information

NPI Number	:	1902949621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACEO BARBER

Provider Business Mailing Address
First Line	:	1850 EL PARQUE CT APT C
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-2036
Country	:	US
Telephone Number	:	650-357-7660
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 S VAN NESS AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-1908
Country	:	US
Telephone Number	:	415-642-4502
Fax Number	:	415-642-4502

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/24/2008

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Directions to “ MACEO BARBER ” Practice Location

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