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General NPI Number Information
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NPI Number | 1427488485
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Entity Type | Individual
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Provider Name | TEJAL J PATEL MFT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 978 W ALLUVIAL AVE STE 107
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City | FRESNO
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State | CA
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Zip | 93711-5502
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Country | US
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Telephone | 559-478-9153
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Fax |
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Provider Business Mailing Address
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Address Line | 133 DENALI
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City | LAKE FOREST
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State | CA
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Zip | 92630-7632
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Country | US
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Telephone | 559-493-8200
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 100043AN
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 77631
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License Number State | CA
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