Provider Demographics
NPI:1063135440
Name:BARRETTE, ANNA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MICHELLE
Last Name:BARRETTE
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 1:2988 WAUNETA ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-4437
Mailing Address - Country:US
Mailing Address - Phone:818-731-2284
Mailing Address - Fax:
Practice Address - Street 1:5301 VIA PISA
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-7007
Practice Address - Country:US
Practice Address - Phone:818-731-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113259106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist