Provider Demographics
NPI:1053298422
Name:FAMBO-DEMARTEAU, AJAH-CHRISTINE DENISE (PHD, AAP, VAIDYA)
Entity type:Individual
Prefix:DR
First Name:AJAH-CHRISTINE
Middle Name:DENISE
Last Name:FAMBO-DEMARTEAU
Suffix:
Gender:F
Credentials:PHD, AAP, VAIDYA
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:CHRISTINE
Other - Last Name:FAMBO-DEMARTEAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, AAP, VAIDYA , C
Mailing Address - Street 1:13900 MARQUESAS WAY APT 3109
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6024
Mailing Address - Country:US
Mailing Address - Phone:431-059-3304
Mailing Address - Fax:
Practice Address - Street 1:26877 SNOWMASS LOOP
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91381-2408
Practice Address - Country:US
Practice Address - Phone:310-593-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist