Provider Demographics
NPI:1235507815
Name:BISHOP, BARBARA (LMFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 W 9TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-3638
Mailing Address - Country:US
Mailing Address - Phone:310-245-0516
Mailing Address - Fax:
Practice Address - Street 1:732 W 9TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3638
Practice Address - Country:US
Practice Address - Phone:310-245-0516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-12
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38391106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist