Provider Demographics
NPI:1023215605
Name:PRESLEY, AMY (MFT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MAYHEW WAY
Mailing Address - Street 2:SUITE 503
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4328
Mailing Address - Country:US
Mailing Address - Phone:925-946-2874
Mailing Address - Fax:925-946-2876
Practice Address - Street 1:140 MAYHEW WAY
Practice Address - Street 2:SUITE 503
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4328
Practice Address - Country:US
Practice Address - Phone:925-946-2874
Practice Address - Fax:925-946-2876
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist