Provider Demographics
NPI:1003027111
Name:GIOIA, LISA G (MS, MFT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:G
Last Name:GIOIA
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 MOHR AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4678
Mailing Address - Country:US
Mailing Address - Phone:925-202-4533
Mailing Address - Fax:
Practice Address - Street 1:4133 MOHR AVE
Practice Address - Street 2:SUITE I
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4678
Practice Address - Country:US
Practice Address - Phone:925-202-4533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC17824106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8179OtherDMH MEDICAL PROVIDER #