Provider Demographics
NPI:1164507950
Name:LEVINE, BARRY J (PSYD, MFT)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:J
Last Name:LEVINE
Suffix:
Gender:M
Credentials:PSYD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27125 SIERRA HWY.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-5431
Mailing Address - Country:US
Mailing Address - Phone:661-877-8378
Mailing Address - Fax:
Practice Address - Street 1:27125 SIERRA HWY.
Practice Address - Street 2:SUITE 305
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-5431
Practice Address - Country:US
Practice Address - Phone:661-877-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC14080106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist