Healthcare Provider Details

I. General information

NPI: 1205762275
Provider Name (Legal Business Name): BARRY THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25436 SAND CREEK TRL
MORENO VALLEY CA
92557-7536
US

IV. Provider business mailing address

25436 SAND CREEK TRL
MORENO VALLEY CA
92557-7536
US

V. Phone/Fax

Practice location:
  • Phone: 909-353-1167
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NAVETA BARRY
Title or Position: OWNER, MANAGING MEMBER, OR CLINICAL
Credential: LMFT
Phone: 909-353-1167