Provider Demographics
NPI:1336545599
Name:TATREAU, AMY (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:TATREAU
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 AUBURN BLVD STE C207
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2082
Mailing Address - Country:US
Mailing Address - Phone:916-905-4393
Mailing Address - Fax:
Practice Address - Street 1:3650 AUBURN BLVD
Practice Address - Street 2:C208
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821
Practice Address - Country:US
Practice Address - Phone:916-905-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106514106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA106514OtherLICENSED MARRIAGE AND FAMILY THERAPIST