Provider Demographics
NPI:1093141640
Name:FARHAT, BOBBY (MFT)
Entity Type:Individual
Prefix:
First Name:BOBBY
Middle Name:
Last Name:FARHAT
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 1:160 SARATOGA AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7334
Mailing Address - Country:US
Mailing Address - Phone:408-306-4428
Mailing Address - Fax:
Practice Address - Street 1:160 SARATOGA AVE STE 210
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7334
Practice Address - Country:US
Practice Address - Phone:408-347-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-15
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist