Provider Demographics
NPI:1114513801
Name:DUFFEY, PATRICK JOHN (MS, LPCC, CRC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:DUFFEY
Suffix:
Gender:M
Credentials:MS, LPCC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 OTIS DR APT F
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5659
Mailing Address - Country:US
Mailing Address - Phone:707-342-1305
Mailing Address - Fax:
Practice Address - Street 1:2029 OTIS DR APT F
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5659
Practice Address - Country:US
Practice Address - Phone:707-342-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC459101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional