Marykate Elizabeth Fitzpatrick

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1438180721 Issued in CA

Practice address

955 W Center St Ste 12
Manteca, CA 95337-7300

Phone

(209) 239-9600

NPI assigned

Sep 26, 2018

Last updated

Jul 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Forward SF, Inc.

  dba A Woman's Place

  • Substance Abuse Rehabilitation Facility
  • San Francisco, CA
  • NPI 1619007986
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1427533348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2686 SPRING ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633522",
            "telephone_number": "650-368-3345",
            "fax_number": "510-879-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W CENTER ST STE 12",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377300",
            "telephone_number": "209-239-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2686 Spring St",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940633522",
            "country_code": "US",
            "telephone_number": "650-368-3345",
            "fax_number": "510-879-0354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "MARYKATE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1438180721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Choice Physician Partners (Greater Modesto Medical Surgical Associates)
• First Choice Physician Partners (Greater Modesto Medical Surgical Associates)
• First Choice Physician Partners (Greater Modesto Medical Surgical Associates)
• First Choice Physician Partners (Greater Modesto Medical Surgical Associates)
• Firstsight Vision Services, Inc.
• Florinda G. Mallorca, M.D. Inc
• Foad Elahi MD California Center of Pain Medicine and Rehabilitation I
• Amanda Nicole Cervantes Fontes, OTR/L
• Cindy Ford, MFT
• Ariana Fraga

• Addiction (Substance Use Disorder) Counselor in Manteca, CA
• Providers in Manteca, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.