Provider Demographics
NPI:1760263958
Name:FITZPATRICK, PATRICK JOSEPH (AMFT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 EWART DL
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3159
Mailing Address - Country:US
Mailing Address - Phone:510-499-9999
Mailing Address - Fax:
Practice Address - Street 1:2730 SALVIO ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2599
Practice Address - Country:US
Practice Address - Phone:925-386-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist