Provider Demographics
NPI:1043581093
Name:GHIO, DARIO (MFT INTERN)
Entity Type:Individual
Prefix:
First Name:DARIO
Middle Name:
Last Name:GHIO
Suffix:
Gender:M
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 W 25TH ST # 257
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-4415
Mailing Address - Country:US
Mailing Address - Phone:310-707-5520
Mailing Address - Fax:
Practice Address - Street 1:624 W 9TH ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3158
Practice Address - Country:US
Practice Address - Phone:310-707-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALMFT108955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health