Provider Demographics
NPI:1235350372
Name:HARRIS, AMY S (MFT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:S
Last Name:HARRIS
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 1:900 WELCH ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1804
Mailing Address - Country:US
Mailing Address - Phone:650-888-1070
Mailing Address - Fax:
Practice Address - Street 1:900 WELCH ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1804
Practice Address - Country:US
Practice Address - Phone:650-888-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist