Provider Demographics
NPI:1942401385
Name:SERRANO, PATRICIA (MFT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:PUNCSAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 FRUITVALE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2322
Mailing Address - Country:US
Mailing Address - Phone:510-535-6200
Mailing Address - Fax:510-535-4167
Practice Address - Street 1:1501 FRUITVALE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-2322
Practice Address - Country:US
Practice Address - Phone:510-535-6200
Practice Address - Fax:510-535-4167
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47173106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist