Provider Demographics
NPI:1881710895
Name:MANESH, FARIBA (MFT)
Entity type:Individual
Prefix:
First Name:FARIBA
Middle Name:
Last Name:MANESH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23147 VENTURA BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-0710
Mailing Address - Country:US
Mailing Address - Phone:818-523-7711
Mailing Address - Fax:818-479-9494
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
Practice Address - Country:US
Practice Address - Phone:818-523-7711
Practice Address - Fax:818-479-9494
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist