Provider Demographics
NPI:1750155933
Name:HADDAD, JOSEPH ELIAS
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ELIAS
Last Name:HADDAD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:ELIAS
Other - Last Name:HADDAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4453 PALMERO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-4248
Mailing Address - Country:US
Mailing Address - Phone:347-463-7762
Mailing Address - Fax:
Practice Address - Street 1:23147 VENTURA BLVD STE 250
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-0710
Practice Address - Country:US
Practice Address - Phone:213-770-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist