Provider Demographics
NPI:1053672774
Name:TEMPLETON, ANDREA LYNNE (AMFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LYNNE
Last Name:TEMPLETON
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 W SHAW AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3519
Mailing Address - Country:US
Mailing Address - Phone:559-436-0482
Mailing Address - Fax:
Practice Address - Street 1:1690 W SHAW AVE STE 201
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3519
Practice Address - Country:US
Practice Address - Phone:559-436-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70852101YM0800X
CA106948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106948OtherBOARD OF BEHAVIORAL SCIENCES