Provider Demographics
NPI:1942733225
Name:FARACH, GABRIELA MARIA (MSW)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:MARIA
Last Name:FARACH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:MARIA
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:746 LYNNMERE DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1926
Mailing Address - Country:US
Mailing Address - Phone:805-404-1020
Mailing Address - Fax:
Practice Address - Street 1:746 LYNNMERE DR
Practice Address - Street 2:746
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1926
Practice Address - Country:US
Practice Address - Phone:805-404-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW737371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical