Provider Demographics
NPI:1497406342
Name:NEDJAT-HAIEM, FRANCES (LCSW)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:NEDJAT-HAIEM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15243 LA CRUZ DR UNIT 1388
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-5395
Mailing Address - Country:US
Mailing Address - Phone:310-948-0045
Mailing Address - Fax:
Practice Address - Street 1:17165 AVENIDA DE SANTA YNEZ
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2134
Practice Address - Country:US
Practice Address - Phone:310-948-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA280891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical