Provider Demographics
NPI:1255487054
Name:FITZPATRICK-FLORES, EILEEN (MFT)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:
Last Name:FITZPATRICK-FLORES
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 1:306 N CURTIS AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-2120
Mailing Address - Country:US
Mailing Address - Phone:626-282-7503
Mailing Address - Fax:626-289-3247
Practice Address - Street 1:1000 S FREMONT AVE UNIT 30
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-8864
Practice Address - Country:US
Practice Address - Phone:626-282-7503
Practice Address - Fax:626-289-3247
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24649106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist