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General NPI Number Information
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NPI Number | 1336206648
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Entity Type | Individual
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Provider Name | CORY MARIE FITZPATRICK PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 2031 HOWE AVE STE 200
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City | SACRAMENTO
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State | CA
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Zip | 95825-0178
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Country | US
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Telephone | 916-541-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 2345 FAIR OAKS BLVD MENTAL HEALTH #15
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City | SACRAMENTO
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State | CA
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Zip | 95825-4708
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Country | US
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Telephone | 916-480-6914
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Fax | 916-480-6920
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18294
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License Number State | CA
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