Provider Demographics
NPI:1790098697
Name:BATTERTON, AMY SUE (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:SUE
Last Name:BATTERTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-1653
Mailing Address - Country:US
Mailing Address - Phone:925-777-9540
Mailing Address - Fax:925-757-9024
Practice Address - Street 1:509 W 10TH ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1653
Practice Address - Country:US
Practice Address - Phone:925-777-9540
Practice Address - Fax:925-757-9024
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist