Provider Demographics
NPI:1376807636
Name:PATEL, AMI LALIT (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:LALIT
Last Name:PATEL
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3734 S CANFIELD AVE APT 331
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-4163
Mailing Address - Country:US
Mailing Address - Phone:301-908-9556
Mailing Address - Fax:
Practice Address - Street 1:3734 S CANFIELD AVE APT 331
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-4163
Practice Address - Country:US
Practice Address - Phone:301-908-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99802106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist