Provider Demographics
NPI:1467334854
Name:FAKHOURY, HANIEH ATEF (MS)
Entity type:Individual
Prefix:
First Name:HANIEH
Middle Name:ATEF
Last Name:FAKHOURY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 W FOOTHILL BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3854
Mailing Address - Country:US
Mailing Address - Phone:909-982-5050
Mailing Address - Fax:909-982-5252
Practice Address - Street 1:299 W FOOTHILL BLVD STE 111
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3854
Practice Address - Country:US
Practice Address - Phone:909-982-5050
Practice Address - Fax:909-982-5252
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker