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Fremont Psychotherapy Graciela M. Fix, LEFT (#47357) 39812 Mission Blvd., Suite 106 Fremont, CA 94539 P:510.585.3514 F:888.549.3566CLIENT INTAKE Format: Name: Date of Birth: Address: City: State:
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Fremont psychoformrapy is a form used to report psychotherapy services provided by mental health professionals in the city of Fremont.
All mental health professionals providing psychotherapy services in Fremont are required to file Fremont psychoformrapy.
Fremont psychoformrapy can be filled out online on the city's official website or submitted in person at the municipal office.
The purpose of Fremont psychoformrapy is to track and monitor psychotherapy services provided in the city for regulatory and statistical purposes.
Fremont psychoformrapy requires reporting of the mental health professional's contact information, patient demographics, type of therapy provided, and billing details.
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