Provider Demographics
NPI:1558654400
Name:FASHEH, MONA MARIE
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:MARIE
Last Name:FASHEH
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 1:24416 FIELDMONT PL
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3825
Mailing Address - Country:US
Mailing Address - Phone:818-261-5625
Mailing Address - Fax:
Practice Address - Street 1:24416 FIELDMONT PL
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3825
Practice Address - Country:US
Practice Address - Phone:818-261-5625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool