Provider Demographics
NPI:1174193817
Name:NEUFELD, TIMOTHY DON (LMFT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:DON
Last Name:NEUFELD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 E KELSO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-5349
Mailing Address - Country:US
Mailing Address - Phone:559-999-0861
Mailing Address - Fax:
Practice Address - Street 1:8483 N MILLBROOK AVE STE 110
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2153
Practice Address - Country:US
Practice Address - Phone:559-242-6256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT136666106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist