Provider Demographics
NPI:1851502678
Name:RAIMER, FAITH (LMFT)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:RAIMER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2667 N MOORPARK RD STE 111
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-3025
Mailing Address - Country:US
Mailing Address - Phone:805-241-3221
Mailing Address - Fax:
Practice Address - Street 1:2667 N MOORPARK RD STE 111
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-3025
Practice Address - Country:US
Practice Address - Phone:805-241-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 22427106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist