Provider Demographics
NPI:1336491935
Name:ZAWAYDEH-FAKHOURI, KARLA (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:
Last Name:ZAWAYDEH-FAKHOURI
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JOYCE RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:CA
Mailing Address - Zip Code:94010-7316
Mailing Address - Country:US
Mailing Address - Phone:415-307-1549
Mailing Address - Fax:
Practice Address - Street 1:35 JOYCE RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:CA
Practice Address - Zip Code:94010-7316
Practice Address - Country:US
Practice Address - Phone:415-307-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist