Provider Demographics
NPI:1114011574
Name:BIANCHINA, MARY JO (MFT-INTERN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:JO
Last Name:BIANCHINA
Suffix:
Gender:F
Credentials:MFT-INTERN
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:JO
Other - Last Name:BIANCHINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT-TRAINEE
Mailing Address - Street 1:7 GOVERNORS LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1990
Mailing Address - Country:US
Mailing Address - Phone:530-267-1760
Mailing Address - Fax:
Practice Address - Street 1:7 GOVERNORS LN
Practice Address - Street 2:SUITE 110
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1990
Practice Address - Country:US
Practice Address - Phone:530-267-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46495106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist