Provider Demographics
NPI:1669923025
Name:CONTRERAS AMADOR, FATIMA (MFTI)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:CONTRERAS AMADOR
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:FATIMA
Other - Middle Name:
Other - Last Name:CONTRERAS AMADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 2267
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:CA
Mailing Address - Zip Code:93926-2267
Mailing Address - Country:US
Mailing Address - Phone:831-744-6393
Mailing Address - Fax:
Practice Address - Street 1:30 E SAN JOAQUIN ST STE 201
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2947
Practice Address - Country:US
Practice Address - Phone:831-744-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139020106H00000X
CA98125101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health