Provider Demographics
NPI:1215176813
Name:MCDERMOTT, PATRICIA J (MFT)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:J
Last Name:MCDERMOTT
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 1:140 W FRANKLIN ST
Mailing Address - Street 2:203
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-372-5365
Mailing Address - Fax:831-372-9167
Practice Address - Street 1:140 W FRANKLIN ST
Practice Address - Street 2:203
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-372-5365
Practice Address - Fax:831-372-9167
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18697106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist