AMANDA RAQUEL PORTILLO (NPI# 1255882577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255882577 |
| Entity Type | Individual |
| Full Name | AMANDA RAQUEL PORTILLO |
| Credential | MFTI |
| Practice Address |
1234 Empire St Suite 2300 Fairfield CA 94533-5711 |
| Practice Telephone | 7073847303 |
| Practice Fax Number | 7072474233 |
| Mailing Telephone | 7075143764 |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 95665 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1234 EMPIRE ST SUITE 2300 |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-5711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215024591 | Henry H Collins | Pediatrics | 1234 Empire St, Fairfield, CA 94533-5711 | 2006-10-06 |
| 1144870304 | Diandria Aliysha Donaldson | Counselor | 1234 Empire St, Fairfield, CA 94533-5711 | 2019-09-18 |
| 1790265833 | Yasmina Ehab Bazaraa | Counselor | 1234 Empire St, Fairfield, CA 94533-5711 | 2018-08-17 |
| 1730686171 | Miarah Jones | Counselor | 1234 Empire St, Fairfield, CA 94533 | 2018-04-11 |
| 1609376920 | Roxanne Michelle Rodeznomedearis | Counselor | 1234 Empire St, Fairfield, CA 94533-5711 | 2018-02-13 |
| 1699224659 | Melissa Mae Torrez | Counselor | 1234 Empire St, Fairfield, CA 94533-5711 | 2016-09-30 |
| 1144680513 | Kevin Anderson | Marriage & Family Therapist | 1234 Empire St, Fairfield, CA 94533-5711 | 2016-02-29 |
| 1194198580 | Camilia Kaye Shoulders | Counselor | 1234 Empire St, Fairfield, CA 94533-5711 | 2015-11-05 |
| 1770959181 | Rosemary O'leary | Counselor | 1234 Empire St, Fairfield, CA 94533-5711 | 2015-08-19 |
| 1942602701 | Kellie Rayann Kennedy | Counselor | 1234 Empire St, Suite 1500, Fairfield, CA 94533-5711 | 2014-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262810 | Stacie Handel | Marriage & Family Therapist | 859 Kings Hwy E, Fairfield, CT 06825-5421 | 2020-10-09 |
| 1770192023 | Rosaura De Alvarez | Marriage & Family Therapist | 1745 Enterprise Dr Ste 1a, Fairfield, CA 94533-5838 | 2020-07-23 |
| 1235751348 | Kr Counseling, LLC | Marriage & Family Therapist | 530 Unquowa Rd, Fairfield, CT 06824-5034 | 2020-05-12 |
| 1154942803 | Laura Pitaniello | Marriage & Family Therapist | 147 Trillium Rd, Fairfield, CT 06824-2439 | 2020-05-05 |
| 1114554649 | Juliette Brisman Zuckerman | Marriage & Family Therapist | 2452 Black Rock Tpke Ste O5, Fairfield, CT 06825-2416 | 2020-03-25 |
| 1730720145 | L Burke LLC | Marriage & Family Therapist | 2501 Old Post Rd, 2nd Floor, Fairfield, CT 06825 | 2019-10-07 |
| 1114576600 | Casey Ann Verlee Johnston | Marriage & Family Therapist | 103 E Adams Ave, Fairfield, IA 52556-3461 | 2019-09-06 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1558922187 | Solano County Superintendent of Schools | Marriage & Family Therapist | 5100 Business Center Drive, Fairfield, CA 94534 | 2019-06-25 |
| 1790242709 | Senja Foster, LLC | Marriage & Family Therapist | 1559 Post Rd Ste 8, Fairfield, CT 06824-5933 | 2019-02-26 |
| Find all providers in FAIRFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.