Provider Demographics
NPI:1881959567
Name:HERRERA, PATRICIA ELEANOR (MFT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELEANOR
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 DIVISION ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6684
Mailing Address - Country:US
Mailing Address - Phone:925-417-8940
Mailing Address - Fax:
Practice Address - Street 1:344 DIVISION ST
Practice Address - Street 2:SUITE 209
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6684
Practice Address - Country:US
Practice Address - Phone:925-417-8940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37738106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist