Healthcare Provider Details

I. General information

NPI: 1467469353
Provider Name (Legal Business Name): CHARLES R BARR PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 N EL MOLINO AVE SUITE 220
PASADENA CA
91101
US

IV. Provider business mailing address

131 N EL MOLINO AVE SUITE 220
PASADENA CA
91101
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-5589
  • Fax: 626-449-5465
Mailing address:
  • Phone: 626-449-5589
  • Fax: 626-449-5465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY06397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: