Provider Demographics
NPI:1902453954
Name:PAGUD PAHED, FENELA (LMFT138418)
Entity Type:Individual
Prefix:
First Name:FENELA
Middle Name:
Last Name:PAGUD PAHED
Suffix:
Gender:F
Credentials:LMFT138418
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11421 RINCON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-4140
Mailing Address - Country:US
Mailing Address - Phone:818-714-9139
Mailing Address - Fax:
Practice Address - Street 1:15720 VENTURA BLVD STE 420
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4711
Practice Address - Country:US
Practice Address - Phone:818-927-0478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138418106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist