Provider Demographics
NPI:1871501163
Name:BARRY, HELANA (PHD)
Entity Type:Individual
Prefix:DR
First Name:HELANA
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 YARMOUTH RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-2654
Mailing Address - Country:US
Mailing Address - Phone:310-544-2260
Mailing Address - Fax:310-544-2260
Practice Address - Street 1:716 YARMOUTH RD
Practice Address - Street 2:SUITE 210
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-2654
Practice Address - Country:US
Practice Address - Phone:310-544-2260
Practice Address - Fax:310-544-2260
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4705103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR79880Medicare UPIN
CA00PL47050Medicare ID - Type Unspecified