Provider Demographics
NPI:1932531233
Name:DURST, AMY ROCHELLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:ROCHELLE
Last Name:DURST
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ROCHELLE
Other - Last Name:BORGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT 102883
Mailing Address - Street 1:PO BOX 7957
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7957
Mailing Address - Country:US
Mailing Address - Phone:559-707-7717
Mailing Address - Fax:559-608-5707
Practice Address - Street 1:5215 W NOBLE AVE STE 102
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8355
Practice Address - Country:US
Practice Address - Phone:559-707-7717
Practice Address - Fax:559-608-5707
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102883106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist