Provider Demographics
NPI:1295603967
Name:ASSEFNIA, FERIAL
Entity type:Individual
Prefix:
First Name:FERIAL
Middle Name:
Last Name:ASSEFNIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 NEOTOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7560
Mailing Address - Country:US
Mailing Address - Phone:707-483-5696
Mailing Address - Fax:
Practice Address - Street 1:1605 NEOTOMAS AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7560
Practice Address - Country:US
Practice Address - Phone:707-483-5696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-25
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW29153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health