Provider Demographics
NPI:1184499899
Name:FARRAR, DORATHEA C (PHD, LMFT)
Entity type:Individual
Prefix:
First Name:DORATHEA
Middle Name:C
Last Name:FARRAR
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:DORTEE
Other - Middle Name:
Other - Last Name:FARRAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:120 FRASER
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405
Mailing Address - Country:US
Mailing Address - Phone:310-266-1518
Mailing Address - Fax:
Practice Address - Street 1:2812 SANTA MONICA BLVD. SUITE 200
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-266-1518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT6249106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist