Provider Demographics
NPI:1558683300
Name:DAMERY, PATRICIA (MFT, CERTIFIED JUNGI)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:DAMERY
Suffix:
Gender:F
Credentials:MFT, CERTIFIED JUNGI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2218
Mailing Address - Country:US
Mailing Address - Phone:707-252-8650
Mailing Address - Fax:
Practice Address - Street 1:2337 2ND ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2218
Practice Address - Country:US
Practice Address - Phone:707-252-8650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMK7944102L00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist