Provider Demographics
NPI:1134352537
Name:BACHTLE, CECELIA FERNANDEZ (LMFT)
Entity type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:FERNANDEZ
Last Name:BACHTLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CECELIA
Other - Middle Name:FERNANDEZ
Other - Last Name:DONNELLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1122 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3955
Mailing Address - Country:US
Mailing Address - Phone:858-531-1941
Mailing Address - Fax:
Practice Address - Street 1:1130 2ND AVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3955
Practice Address - Country:US
Practice Address - Phone:858-531-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52584106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist