Provider Demographics
NPI:1649346206
Name:OAKES, FAYETTE HANCOCK (MFTI)
Entity type:Individual
Prefix:MRS
First Name:FAYETTE
Middle Name:HANCOCK
Last Name:OAKES
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:FAYETTE
Other - Middle Name:THERESA
Other - Last Name:HANCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:500 CHIQUITA AVE APT 15
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-2701
Mailing Address - Country:US
Mailing Address - Phone:650-960-7166
Mailing Address - Fax:
Practice Address - Street 1:251 LLEWELLYN AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1940
Practice Address - Country:US
Practice Address - Phone:408-937-8017
Practice Address - Fax:408-364-7090
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF41859106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4581OtherSANTA CLARA CO. UNICARE