Provider Demographics
NPI:1942618723
Name:GAFFNEY-AMENT, PATRICIA (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:GAFFNEY-AMENT
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 MERCED ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1721
Mailing Address - Country:US
Mailing Address - Phone:559-892-1128
Mailing Address - Fax:
Practice Address - Street 1:2140 MERCED ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1721
Practice Address - Country:US
Practice Address - Phone:559-892-1128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF76136106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist