Individual
TIMOTHY BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4711
Mailing address
1234 ESTES DR, SANTA MARIA, CA 93454-5978
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PT 32936
CA
167G00000X
Licensed Psychiatric Technician
Primary
PT 32936
CA
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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