Provider Demographics
NPI:1932316288
Name:FERER, DALE (MFT)
Entity Type:Individual
Prefix:MS
First Name:DALE
Middle Name:
Last Name:FERER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:DALE
Other - Middle Name:FERER
Other - Last Name:NISSENSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:2027 SANTA BARBARA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3541
Mailing Address - Country:US
Mailing Address - Phone:805-705-9295
Mailing Address - Fax:805-569-0887
Practice Address - Street 1:14156 MAGNOLIA BLVD
Practice Address - Street 2:STE 105
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-6401
Practice Address - Country:US
Practice Address - Phone:805-705-9295
Practice Address - Fax:805-569-0887
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34205106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist