Provider Demographics
NPI:1194184390
Name:MONICA FARASSAT, MARRIAGE AND FAMILY THERAPY, INCORPORATED
Entity Type:Organization
Organization Name:MONICA FARASSAT, MARRIAGE AND FAMILY THERAPY, INCORPORATED
Other - Org Name:MONICA FARASSAT, PSY.D., LMFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:FARASSAT
Authorized Official - Last Name:KADKHODA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-453-7010
Mailing Address - Street 1:3201 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-2344
Mailing Address - Country:US
Mailing Address - Phone:310-453-7010
Mailing Address - Fax:
Practice Address - Street 1:3201 WILSHIRE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2344
Practice Address - Country:US
Practice Address - Phone:310-453-7010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty