Provider Demographics
NPI:1275758443
Name:BUNKER, PATTY L (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:PATTY
Middle Name:L
Last Name:BUNKER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 N PALM AVE
Mailing Address - Street 2:STE 405
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2211
Mailing Address - Country:US
Mailing Address - Phone:559-222-2300
Mailing Address - Fax:455-944-8022
Practice Address - Street 1:5151 N PALM AVE
Practice Address - Street 2:STE 405
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2211
Practice Address - Country:US
Practice Address - Phone:559-222-2300
Practice Address - Fax:455-944-8022
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMC21130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist