Provider Demographics
NPI:1003056631
Name:DI RIENZO, JULIA GABRIELA (MFT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:GABRIELA
Last Name:DI RIENZO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-0623
Mailing Address - Country:US
Mailing Address - Phone:925-937-9707
Mailing Address - Fax:925-299-1928
Practice Address - Street 1:1460 MARIA LANE STE 310
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:925-937-9707
Practice Address - Fax:925-299-1928
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-22
Last Update Date:2009-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43595106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist