Provider Demographics
NPI:1902025018
Name:BARENFELD, ROBERTA (MFT)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:
Last Name:BARENFELD
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 1:801 OCEAN AVE
Mailing Address - Street 2:#203
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-1039
Mailing Address - Country:US
Mailing Address - Phone:310-433-4105
Mailing Address - Fax:310-434-1407
Practice Address - Street 1:3201 WILSHIRE BLVD
Practice Address - Street 2:#203
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2344
Practice Address - Country:US
Practice Address - Phone:310-453-8093
Practice Address - Fax:310-434-1407
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 28898106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist