Provider Demographics
NPI:1972281822
Name:WARMERDAM, FRANCES JACQUELYN (LMFT)
Entity type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:JACQUELYN
Last Name:WARMERDAM
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 1:101 GEORGIA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-1832
Mailing Address - Country:US
Mailing Address - Phone:510-325-1122
Mailing Address - Fax:
Practice Address - Street 1:101 GEORGIA WAY
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-1832
Practice Address - Country:US
Practice Address - Phone:510-325-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT22534101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor