Provider Demographics
NPI:1033324561
Name:FUGAZI, RHONDA YVONNE (LMFT, LEP)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:YVONNE
Last Name:FUGAZI
Suffix:
Gender:F
Credentials:LMFT, LEP
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 6
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563
Mailing Address - Country:US
Mailing Address - Phone:925-297-5234
Mailing Address - Fax:
Practice Address - Street 1:43 QUAIL COURT SUITE 211
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:925-297-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4005103TS0200X
CA42708106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool