Provider Demographics
NPI:1801234505
Name:FAAS, JOHN WILLIAM (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILLIAM
Last Name:FAAS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23638 LYONS AVE
Mailing Address - Street 2:# 214
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2513
Mailing Address - Country:US
Mailing Address - Phone:661-799-7994
Mailing Address - Fax:661-287-9705
Practice Address - Street 1:23560 LYONS AVE
Practice Address - Street 2:# 204
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2513
Practice Address - Country:US
Practice Address - Phone:661-799-7994
Practice Address - Fax:661-287-9705
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS115601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical