Healthcare Provider Details

I. General information

NPI: 1992456735
Provider Name (Legal Business Name): EMILY ANN FAUSTINI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2022
Last Update Date: 11/14/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

4144 E MENDEZ ST UNIT 215
LONG BEACH CA
90815-2694
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax:
Mailing address:
  • Phone: 559-305-6229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW101744
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: