Provider Demographics
NPI:1922484930
Name:BARR, FELICIA (MFT)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:BARR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:
Other - Last Name:FELOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-795-3619
Mailing Address - Fax:
Practice Address - Street 1:2907 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-4003
Practice Address - Country:US
Practice Address - Phone:650-235-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89223106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist