Provider Demographics
NPI:1538225792
Name:GROVER, BARBARA L (MA MFT)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:GROVER
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 MOORPARK AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1703
Mailing Address - Country:US
Mailing Address - Phone:408-260-7635
Mailing Address - Fax:408-298-1120
Practice Address - Street 1:4100 MOORPARK AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1703
Practice Address - Country:US
Practice Address - Phone:408-260-7635
Practice Address - Fax:408-298-1120
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health