Healthcare Provider Details

I. General information

NPI: 1164830105
Provider Name (Legal Business Name): LAVONN DIANE FARQUHAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15760 VENTURA BLVD STE 800
ENCINO CA
91436-3018
US

IV. Provider business mailing address

414 N GARFIELD AVE
OXNARD CA
93030-3678
US

V. Phone/Fax

Practice location:
  • Phone: 888-588-8995
  • Fax:
Mailing address:
  • Phone: 310-503-9071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW107280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: