Provider Demographics
NPI:1225378326
Name:TOMNITZ, PATTIE A (LMFT)
Entity type:Individual
Prefix:MS
First Name:PATTIE
Middle Name:A
Last Name:TOMNITZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 SOQUEL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2321
Mailing Address - Country:US
Mailing Address - Phone:831-566-6955
Mailing Address - Fax:
Practice Address - Street 1:526 SOQUEL AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2321
Practice Address - Country:US
Practice Address - Phone:831-566-6955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24683106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist