Provider Demographics
NPI:1932305844
Name:TERMEFOROOSH, FARNOUSH (MFT)
Entity Type:Individual
Prefix:
First Name:FARNOUSH
Middle Name:
Last Name:TERMEFOROOSH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S BARRINGTON AVE STE 335
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-7939
Mailing Address - Country:US
Mailing Address - Phone:310-422-1142
Mailing Address - Fax:
Practice Address - Street 1:11340 W OLYMPIC BLVD STE 245
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1697
Practice Address - Country:US
Practice Address - Phone:424-273-5003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41736106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist