Provider Demographics
NPI:1992031231
Name:BISIO, BARBARA E (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:E
Last Name:BISIO
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:PO BOX 504464
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92150-4464
Mailing Address - Country:US
Mailing Address - Phone:588-314-8262
Mailing Address - Fax:
Practice Address - Street 1:9820 WILLOW CREEK RD STE 245
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1116
Practice Address - Country:US
Practice Address - Phone:858-314-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22549103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACN805ZMedicare UPIN
CAW416Medicare PIN