Provider Demographics
NPI:1306969654
Name:BARNARD, CATHERINE A (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:BARNARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 LOMBARD AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-3858
Mailing Address - Country:US
Mailing Address - Phone:619-466-0370
Mailing Address - Fax:442-333-9465
Practice Address - Street 1:626 LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95409
Practice Address - Country:US
Practice Address - Phone:707-326-3409
Practice Address - Fax:442-333-9465
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2017-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 12863103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL128630Medicare ID - Type UnspecifiedPSYCHOLOGIST