Provider Demographics
NPI:1043919723
Name:MARIELLA LAURIOLA PSYCHOLOGIST INC
Entity Type:Organization
Organization Name:MARIELLA LAURIOLA PSYCHOLOGIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-753-9663
Mailing Address - Street 1:21710 STEVENS CREEK BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1174
Mailing Address - Country:US
Mailing Address - Phone:650-753-9663
Mailing Address - Fax:
Practice Address - Street 1:21710 STEVENS CREEK BLVD STE 240
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1174
Practice Address - Country:US
Practice Address - Phone:650-753-9663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty