Provider Demographics
NPI:1346778875
Name:SKY, BARBARA REYNOLDS (MFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:REYNOLDS
Last Name:SKY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ELLEN
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1117 S B ST STE 9
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-4351
Mailing Address - Country:US
Mailing Address - Phone:650-438-1233
Mailing Address - Fax:
Practice Address - Street 1:1117 S B ST STE 9
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4351
Practice Address - Country:US
Practice Address - Phone:650-438-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT22486106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist