Provider Demographics
NPI:1255674180
Name:LYNCH, PATRICIA TIERNEY (MA MDIV)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:TIERNEY
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MA MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-3343
Mailing Address - Country:US
Mailing Address - Phone:408-279-4110
Mailing Address - Fax:408-286-8988
Practice Address - Street 1:86 S 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-2015
Practice Address - Country:US
Practice Address - Phone:408-938-8500
Practice Address - Fax:408-286-8988
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health