Healthcare Provider Details

I. General information

NPI: 1003162165
Provider Name (Legal Business Name): DIANA BARRETT LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2012
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16055 VENTURA BLVD STE 555
ENCINO CA
91436-2607
US

IV. Provider business mailing address

16055 VENTURA BLVD STE 555
ENCINO CA
91436-2607
US

V. Phone/Fax

Practice location:
  • Phone: 818-522-9158
  • Fax:
Mailing address:
  • Phone: 818-522-9158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number102677
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: