Provider Demographics
NPI:1346562865
Name:GARRIDO, AMELIA KAY (LMFT)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:KAY
Last Name:GARRIDO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:KAY
Other - Last Name:SISK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3701 DOUGLAS BLVD.
Mailing Address - Street 2:300
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4241
Mailing Address - Country:US
Mailing Address - Phone:916-749-9072
Mailing Address - Fax:
Practice Address - Street 1:1860 SIERRA GARDENS
Practice Address - Street 2:178
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4241
Practice Address - Country:US
Practice Address - Phone:916-749-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48115106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist