Provider Demographics
NPI:1104103084
Name:LIBET, SHIRLI HAMUDOT (MFT)
Entity type:Individual
Prefix:MRS
First Name:SHIRLI
Middle Name:HAMUDOT
Last Name:LIBET
Suffix:
Gender:
Credentials:MFT
Other - Prefix:MS
Other - First Name:SHIRLI
Other - Middle Name:
Other - Last Name:HAMUDOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:28059 CARAWAY LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3901
Mailing Address - Country:US
Mailing Address - Phone:805-267-9284
Mailing Address - Fax:
Practice Address - Street 1:1800 WESTWIND DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3055
Practice Address - Country:US
Practice Address - Phone:661-327-4252
Practice Address - Fax:661-327-3409
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47822106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist