Provider Demographics
NPI:1104982321
Name:GIBSON-PAUL, BARBARA FAYE (MFT)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:FAYE
Last Name:GIBSON-PAUL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 W CIVIC CENTER DR STE 205
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2251
Mailing Address - Country:US
Mailing Address - Phone:714-245-0045
Mailing Address - Fax:
Practice Address - Street 1:1202 W CIVIC CENTER DR STE 205
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2251
Practice Address - Country:US
Practice Address - Phone:714-245-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28643106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist