Healthcare Provider Details

I. General information

NPI: 1376497123
Provider Name (Legal Business Name): FAITH AND RELATIONSHIPS MARRIAGE & FAMILY THERAPY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5731 W SLAUSON AVE STE 220
CULVER CITY CA
90230-6984
US

IV. Provider business mailing address

5731 W SLAUSON AVE STE 220
CULVER CITY CA
90230-6984
US

V. Phone/Fax

Practice location:
  • Phone: 424-247-6020
  • Fax:
Mailing address:
  • Phone: 424-247-6020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LAKEETA BEHN-VASQUEZ
Title or Position: MARRIAGE & FAMILY THERAPIST/OWNER
Credential: LMFT
Phone: 424-247-6020