Provider Demographics
NPI:1790227593
Name:FERBEZAR, NATALIE MARIE (ASW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:FERBEZAR
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7986 DAGGET ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2321
Mailing Address - Country:US
Mailing Address - Phone:858-262-8504
Mailing Address - Fax:
Practice Address - Street 1:4969 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5813
Practice Address - Country:US
Practice Address - Phone:213-286-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72196101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
190116OtherPROVIDER NUMBER VOLUNTEERS OF AMERICA