Provider Demographics
NPI:1700904950
Name:FAYNSOD, MARISA FENARJIAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:FENARJIAN
Last Name:FAYNSOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3717
Mailing Address - Country:US
Mailing Address - Phone:310-490-9593
Mailing Address - Fax:
Practice Address - Street 1:711 S NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1831
Practice Address - Country:US
Practice Address - Phone:213-807-1897
Practice Address - Fax:213-807-1810
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA270311041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical