Provider Demographics
NPI:1831506633
Name:FARBSTEIN, ALEXANDER SHIBUYA (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:SHIBUYA
Last Name:FARBSTEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 W OLYMPIC BLVD STE 335
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1613
Mailing Address - Country:US
Mailing Address - Phone:424-272-8690
Mailing Address - Fax:
Practice Address - Street 1:11340 W OLYMPIC BLVD STE 335
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1613
Practice Address - Country:US
Practice Address - Phone:424-272-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1010591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical