Provider Demographics
NPI:1679508261
Name:ZEINE, FOOJAN (PSYD, MFT)
Entity Type:Individual
Prefix:DR
First Name:FOOJAN
Middle Name:
Last Name:ZEINE
Suffix:
Gender:F
Credentials:PSYD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5536 TAMPA AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3027
Mailing Address - Country:US
Mailing Address - Phone:818-648-2140
Mailing Address - Fax:818-757-7106
Practice Address - Street 1:5536 TAMPA AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3027
Practice Address - Country:US
Practice Address - Phone:818-648-2140
Practice Address - Fax:818-757-7106
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33723106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMF3372300Medicaid