Provider Demographics
NPI:1760609093
Name:SHAFFER, BARBARA NONE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:NONE
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16550 VENTURA BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2084
Mailing Address - Country:US
Mailing Address - Phone:818-773-3737
Mailing Address - Fax:818-996-0609
Practice Address - Street 1:16550 VENTURA BLVD STE 405
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2084
Practice Address - Country:US
Practice Address - Phone:818-773-3737
Practice Address - Fax:818-996-0609
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37223106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist