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NPI Code Detail

MEDICARE: AMY FITZPATRICK

MEDICARE: AMY FITZPATRICK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1912251851
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY FITZPATRICK
Provider Business Mailing Address
First Line : 2600 S EL CAMINO REAL STE 200
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-2382
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2600 S EL CAMINO REAL STE 200
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-2382
Country : US
Telephone Number : 650-578-8691
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2012
Last Update Date : 10/30/2012

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Directions to “ AMY FITZPATRICK ” Practice Location

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