Provider Demographics
NPI:1972267995
Name:MYERS, ATONTE ROXANNE
Entity Type:Individual
Prefix:
First Name:ATONTE
Middle Name:ROXANNE
Last Name:MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ATONTE
Other - Middle Name:ROXANNE
Other - Last Name:WARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17485 MONTEREY RD
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3671
Mailing Address - Country:US
Mailing Address - Phone:408-465-4300
Mailing Address - Fax:
Practice Address - Street 1:17485 MONTEREY RD
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3671
Practice Address - Country:US
Practice Address - Phone:408-465-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT113957106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist