Provider Demographics
NPI:1659303675
Name:LAFIR, KANEEZA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KANEEZA
Middle Name:
Last Name:LAFIR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12006 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-4119
Mailing Address - Country:US
Mailing Address - Phone:562-773-3044
Mailing Address - Fax:562-929-0516
Practice Address - Street 1:12006 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4119
Practice Address - Country:US
Practice Address - Phone:562-773-3044
Practice Address - Fax:562-929-0516
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19238103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY192380Medicaid
CAPSY192380OtherLICENSE NUMBER
CAPSY192380Medicaid