Basic Information
| Provider Information | |||||||||
| NPI: | 1407987720 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAEEN | ||||||||
| FirstName: | HAYEDE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18331 DELANO ST | ||||||||
| Address2: | |||||||||
| City: | TARZANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913357015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8184009943 | ||||||||
| FaxNumber: | 8183454246 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 S FAIRFAX AVE STE 214 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235380975 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 06/07/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC28035 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.