Provider Demographics
NPI:1366169526
Name:LANDBERG, BARBARA ANN (REHABILITATIVE SERVI)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:LANDBERG
Suffix:
Gender:F
Credentials:REHABILITATIVE SERVI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MYRTLE AVE.
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501
Mailing Address - Country:US
Mailing Address - Phone:707-445-7000
Mailing Address - Fax:707-445-7143
Practice Address - Street 1:901 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501
Practice Address - Country:US
Practice Address - Phone:707-445-7000
Practice Address - Fax:707-445-7143
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist