Provider Demographics
NPI:1174307029
Name:DAVIS-FARASH, JUDY (LMFT)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:DAVIS-FARASH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:D
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:6039 SAUSALITO AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3326
Mailing Address - Country:US
Mailing Address - Phone:818-517-3373
Mailing Address - Fax:
Practice Address - Street 1:6039 SAUSALITO AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3326
Practice Address - Country:US
Practice Address - Phone:818-517-3373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist