Provider Demographics
NPI:1801929468
Name:BARNES, LORI ANNE (IMFT)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANNE
Last Name:BARNES
Suffix:
Gender:F
Credentials:IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 EMERALD AVE # 614
Mailing Address - Street 2:EMERALD MIDDLE SCHOOL
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-7315
Mailing Address - Country:US
Mailing Address - Phone:619-593-7627
Mailing Address - Fax:
Practice Address - Street 1:1221 EMERALD AVE # 614
Practice Address - Street 2:EMERALD MIDDLE SCHOOL
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-7315
Practice Address - Country:US
Practice Address - Phone:619-593-7627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45633106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist