Individual
ANNA FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3615 3/4 BELLEVUE AVE, LOS ANGELES, CA 90026-7502
(732) 404-7963
Mailing address
3615 3/4 BELLEVUE AVE, LOS ANGELES, CA 90026-7502
(732) 404-7963
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
61453581
WA
101YM0800X
Mental Health Counselor
Primary
LH61453581
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2020
Last updated
11/03/2023
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