Provider Demographics
NPI:1447315452
Name:BERK, PERRY (MFT)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:
Last Name:BERK
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 CAMINO DEL REMEDIO
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1332
Mailing Address - Country:US
Mailing Address - Phone:805-681-5244
Mailing Address - Fax:805-681-4382
Practice Address - Street 1:315 CAMINO DEL REMEDIO
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1332
Practice Address - Country:US
Practice Address - Phone:805-681-5244
Practice Address - Fax:805-681-4382
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21196106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist