Provider Demographics
NPI:1992390702
Name:DAVID J. BARRY, III, MARRIAGE AND FAMILY THERAPIST INC.
Entity Type:Organization
Organization Name:DAVID J. BARRY, III, MARRIAGE AND FAMILY THERAPIST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:III
Authorized Official - Credentials:MA
Authorized Official - Phone:650-762-5741
Mailing Address - Street 1:729 GRAPEVINE HWY # 305
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2805
Mailing Address - Country:US
Mailing Address - Phone:650-762-5741
Mailing Address - Fax:650-880-2899
Practice Address - Street 1:1510 FASHION ISLAND BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94404
Practice Address - Country:US
Practice Address - Phone:650-762-5741
Practice Address - Fax:650-880-2899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty