Healthcare Provider Details

I. General information

NPI: 1427267061
Provider Name (Legal Business Name): BARRY LEE HURFORD MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COMMODORE DR D-381
EMERYVILLE CA
94608-1645
US

IV. Provider business mailing address

2 COMMODORE DR D-381
EMERYVILLE CA
94608-1645
US

V. Phone/Fax

Practice location:
  • Phone: 510-547-7265
  • Fax:
Mailing address:
  • Phone: 510-547-7265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC39725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: