Provider Demographics
NPI:1427755594
Name:FIEDTKOU, EMILY DANIELLE (LMFT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:DANIELLE
Last Name:FIEDTKOU
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1222
Mailing Address - Country:US
Mailing Address - Phone:858-248-1104
Mailing Address - Fax:
Practice Address - Street 1:1375 KENWOOD RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-1222
Practice Address - Country:US
Practice Address - Phone:805-909-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT151943106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist