Provider Demographics
NPI:1386832814
Name:BERRY, NYREE RENA
Entity Type:Individual
Prefix:MS
First Name:NYREE
Middle Name:RENA
Last Name:BERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5367
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90224-5367
Mailing Address - Country:US
Mailing Address - Phone:310-637-5400
Mailing Address - Fax:310-637-5454
Practice Address - Street 1:1618 E ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-4408
Practice Address - Country:US
Practice Address - Phone:310-637-5400
Practice Address - Fax:310-637-5454
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor