Provider Demographics
NPI:1831246925
Name:BARRY, SHARLA MARLENE (RN, MFT)
Entity type:Individual
Prefix:MRS
First Name:SHARLA
Middle Name:MARLENE
Last Name:BARRY
Suffix:
Gender:F
Credentials:RN, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5575 LAKE PARK WAY STE 114
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1674
Mailing Address - Country:US
Mailing Address - Phone:619-339-0644
Mailing Address - Fax:619-463-8986
Practice Address - Street 1:5575 LAKE PARK WAY STE 114
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1674
Practice Address - Country:US
Practice Address - Phone:619-339-0644
Practice Address - Fax:619-463-8986
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT36720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health