Provider Demographics
NPI:1407494156
Name:HASSAN, ADENA CHAYA FELLMAN (MS)
Entity Type:Individual
Prefix:
First Name:ADENA
Middle Name:CHAYA FELLMAN
Last Name:HASSAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3954
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91617-3954
Mailing Address - Country:US
Mailing Address - Phone:858-740-1361
Mailing Address - Fax:
Practice Address - Street 1:99 ALMADEN BLVD STE 600
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1605
Practice Address - Country:US
Practice Address - Phone:408-402-4385
Practice Address - Fax:954-480-1784
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist