Provider Demographics
NPI:1114727799
Name:BARNES, CORDIA
Entity type:Individual
Prefix:
First Name:CORDIA
Middle Name:
Last Name:BARNES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-5211
Mailing Address - Country:US
Mailing Address - Phone:925-214-3627
Mailing Address - Fax:
Practice Address - Street 1:60 GOLD CREST CT
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6500
Practice Address - Country:US
Practice Address - Phone:925-267-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker