Provider Demographics
NPI:1225163504
Name:FACIANE, LANAE (MFT)
Entity Type:Individual
Prefix:MS
First Name:LANAE
Middle Name:
Last Name:FACIANE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5740 RALSTON ST.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7847
Mailing Address - Country:US
Mailing Address - Phone:805-654-5570
Mailing Address - Fax:805-648-9662
Practice Address - Street 1:5740 RALSTON ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7847
Practice Address - Country:US
Practice Address - Phone:805-654-5570
Practice Address - Fax:805-648-9662
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48761106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist