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General NPI Number Information
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NPI Number | 1689710105
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Entity Type | Individual
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Provider Name | ELISABETH FARNSWORTH MA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 515 E 1ST ST
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City | TUSTIN
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State | CA
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Zip | 92780-3335
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Country | US
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Telephone | 949-246-5062
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Fax | 714-378-9741
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Provider Business Mailing Address
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Address Line | 10449 THRUSH AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7106
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Country | US
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Telephone | 714-379-9740
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Fax | 714-378-9741
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 40872
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License Number State | CA
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