Healthcare Provider Details

I. General information

NPI: 1003034133
Provider Name (Legal Business Name): DOLORES GIAMMARISE AMATO MS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. DOLORES G HEINLEN

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 11/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6777 N WILLOW AVE #141
FRESNO CA
93710-5900
US

IV. Provider business mailing address

6777 N WILLOW AVE #141
FRESNO CA
93710-5900
US

V. Phone/Fax

Practice location:
  • Phone: 559-298-7230
  • Fax: 888-730-7357
Mailing address:
  • Phone: 559-298-7230
  • Fax: 888-730-7357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT37387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: