Provider Demographics
NPI:1316818941
Name:MCFATE, JOSHUA SHANE
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:SHANE
Last Name:MCFATE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 LAS FLORES RD APT 31
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-1454
Mailing Address - Country:US
Mailing Address - Phone:925-596-1122
Mailing Address - Fax:
Practice Address - Street 1:851 LAS FLORES RD APT 31
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-1454
Practice Address - Country:US
Practice Address - Phone:925-596-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22709101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)