Provider Demographics
NPI:1083102776
Name:FARAONE, LENORE (RBT)
Entity Type:Individual
Prefix:
First Name:LENORE
Middle Name:
Last Name:FARAONE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:LENNE
Other - Middle Name:
Other - Last Name:FARAONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9906 NE 190TH ST APT C
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-2950
Mailing Address - Country:US
Mailing Address - Phone:415-989-5000
Mailing Address - Fax:
Practice Address - Street 1:744 MONTGOMERY ST STE 400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-2123
Practice Address - Country:US
Practice Address - Phone:415-989-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician