Provider Demographics
NPI:1790142792
Name:FITZPATRICK, KATE (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:
Last Name:FITZPATRICK
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 1:17326 EDWARDS RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2443
Mailing Address - Country:US
Mailing Address - Phone:424-259-1592
Mailing Address - Fax:
Practice Address - Street 1:17326 EDWARDS RD
Practice Address - Street 2:SUITE 115
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2443
Practice Address - Country:US
Practice Address - Phone:424-259-1592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80909106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist