Provider Demographics
NPI:1720116155
Name:FAUBUS, MEGAN DENISE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:DENISE
Last Name:FAUBUS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:DENISE
Other - Last Name:CLUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 22382
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2382
Mailing Address - Country:US
Mailing Address - Phone:661-333-0776
Mailing Address - Fax:
Practice Address - Street 1:841 MOHAWK ST STE 120
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1500
Practice Address - Country:US
Practice Address - Phone:661-333-0776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52344106H00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator