Provider Demographics
NPI:1720722572
Name:FATHY, CHIRAZ EL HELOU (MA, AMFT)
Entity type:Individual
Prefix:
First Name:CHIRAZ
Middle Name:EL HELOU
Last Name:FATHY
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4101
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92334-4101
Mailing Address - Country:US
Mailing Address - Phone:909-213-1134
Mailing Address - Fax:
Practice Address - Street 1:13591 BETSY ROSS CT
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-3423
Practice Address - Country:US
Practice Address - Phone:323-929-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist