MEDICARE: DR. MICHELLE BARAHMAN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY33377	CA
2	103TC0700X	Clinical Psychologist	023475	NY

General Provider Information

NPI Number	:	1356983837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE BARAHMAN PH.D.

Provider Business Mailing Address
First Line	:	6977 NAVAJO RD UNIT 514
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1503
Country	:	US
Telephone Number	:	347-812-9720
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 MISSION MESA WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-1557
Country	:	US
Telephone Number	:	347-812-9720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2019
Last Update Date	:	09/16/2025

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