Provider Demographics
NPI:1255519765
Name:BARRY, SHEILA LYNN
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:LYNN
Last Name:BARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 10TH ST
Mailing Address - Street 2:APT#4
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-4715
Mailing Address - Country:US
Mailing Address - Phone:562-253-7264
Mailing Address - Fax:
Practice Address - Street 1:1078 ATLANTIC AVE
Practice Address - Street 2:WELNESS CENTER
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813
Practice Address - Country:US
Practice Address - Phone:562-285-0149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator