Basic Information
| Provider Information | |||||||||
| NPI: | 1922509710 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARTON | ||||||||
| FirstName: | CIERRA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 FAIRWAY DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334411834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9257852657 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5820 STONERIDGE MALL ROAD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8775002186 | ||||||||
| FaxNumber: | 8665002186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2018 | ||||||||
| LastUpdateDate: | 05/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 103K00000X | 1-18-34312 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.