Provider Demographics
NPI:1306135348
Name:BAR, AUDREY ZORNIZER
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:ZORNIZER
Last Name:BAR
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 1:1800 COLBY AVE
Mailing Address - Street 2:303
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5465
Mailing Address - Country:US
Mailing Address - Phone:805-643-1446
Mailing Address - Fax:
Practice Address - Street 1:856 E THOMPSON BLVD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2918
Practice Address - Country:US
Practice Address - Phone:805-643-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health