Provider Demographics
NPI:1992805956
Name:ABITBOL, FAYE FERIDA (MARRIAGE FAMILY THER)
Entity type:Individual
Prefix:MS
First Name:FAYE
Middle Name:FERIDA
Last Name:ABITBOL
Suffix:
Gender:F
Credentials:MARRIAGE FAMILY THER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MISSION ST
Mailing Address - Street 2:STE G
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060
Mailing Address - Country:US
Mailing Address - Phone:831-425-0679
Mailing Address - Fax:831-425-4552
Practice Address - Street 1:406 MISSION ST
Practice Address - Street 2:STE G
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060
Practice Address - Country:US
Practice Address - Phone:831-425-0679
Practice Address - Fax:831-425-4552
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32092MFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist