Provider Demographics
NPI:1508262411
Name:FITZPATRICK, ERIN CATHERINE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CATHERINE
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:CATHERINE
Other - Last Name:FITZPATRICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1221 E. DYER ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:714-323-0471
Mailing Address - Fax:
Practice Address - Street 1:1221 E DYER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5600
Practice Address - Country:US
Practice Address - Phone:714-323-0471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121371106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist