Provider Demographics
NPI:1093571010
Name:BYRD, DAVID (LMFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BYRD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1709 ROWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1709 ROWLAND AVE
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3156
Practice Address - Country:US
Practice Address - Phone:805-910-8793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111634106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist