Provider Demographics
NPI:1467172650
Name:FERSTENBERG, YOCHEVED (PSYD)
Entity Type:Individual
Prefix:
First Name:YOCHEVED
Middle Name:
Last Name:FERSTENBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AYDEN
Other - Middle Name:
Other - Last Name:FERSTENBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12-11 20TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2307
Mailing Address - Country:US
Mailing Address - Phone:862-249-0946
Mailing Address - Fax:
Practice Address - Street 1:12-11 20TH ST
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2307
Practice Address - Country:US
Practice Address - Phone:862-249-0946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY025996103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program