Provider Demographics
NPI:1255513172
Name:FITZGERALD, PATRICK (MFT)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 GEARY BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1834
Mailing Address - Country:US
Mailing Address - Phone:415-386-6600
Mailing Address - Fax:415-751-3226
Practice Address - Street 1:6221 GEARY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1834
Practice Address - Country:US
Practice Address - Phone:415-361-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 40990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist