Provider Demographics
NPI:1407668460
Name:BARI, ANEESAH (AMFT)
Entity type:Individual
Prefix:
First Name:ANEESAH
Middle Name:
Last Name:BARI
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 W ARROW HWY APT 3
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4854
Mailing Address - Country:US
Mailing Address - Phone:909-530-7381
Mailing Address - Fax:
Practice Address - Street 1:4193 FLAT ROCK DR STE 200
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-7113
Practice Address - Country:US
Practice Address - Phone:951-292-4693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139731106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist