Provider Demographics
NPI:1073024188
Name:PURKEY, ANGELIE MARIE (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANGELIE
Middle Name:MARIE
Last Name:PURKEY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 VALENCIA AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4165
Mailing Address - Country:US
Mailing Address - Phone:831-460-2550
Mailing Address - Fax:831-688-1718
Practice Address - Street 1:3060 VALENCIA AVE STE 7
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4165
Practice Address - Country:US
Practice Address - Phone:831-460-2550
Practice Address - Fax:831-688-1718
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31384106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist