Provider Demographics
NPI:1285822973
Name:HALOTE, BARRY I (PHD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:HALOTE
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 4368
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91617
Mailing Address - Country:US
Mailing Address - Phone:818-752-3330
Mailing Address - Fax:818-508-4820
Practice Address - Street 1:16311 VENTURA BLVD.
Practice Address - Street 2:SUITE #1050
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-752-3330
Practice Address - Fax:818-508-4820
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10111103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA200354800OtherWORKERS COMPENSATION