Provider Demographics
NPI:1790986628
Name:KIRKPATRICK, JAMES M (MFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1358
Mailing Address - Country:US
Mailing Address - Phone:510-893-9230
Mailing Address - Fax:510-893-2074
Practice Address - Street 1:1727 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:SUITE 109
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1358
Practice Address - Country:US
Practice Address - Phone:510-893-9230
Practice Address - Fax:510-893-2074
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 17408106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist