Provider Demographics
NPI:1265534739
Name:CRAIG, AMELIA O
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:O
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 PEARL ST STE A24
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3062
Mailing Address - Country:US
Mailing Address - Phone:831-622-9092
Mailing Address - Fax:831-625-1563
Practice Address - Street 1:444 PEARL ST STE A24
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3062
Practice Address - Country:US
Practice Address - Phone:831-622-9092
Practice Address - Fax:831-625-1563
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41316106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist