Provider Demographics
NPI:1194814533
Name:DIRIDONI, MARIE (MA MFT)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:DIRIDONI
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 CASS ST
Mailing Address - Street 2:SUITE C4
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4515
Mailing Address - Country:US
Mailing Address - Phone:831-655-0242
Mailing Address - Fax:831-642-0213
Practice Address - Street 1:1010 CASS ST
Practice Address - Street 2:SUITE C4
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4515
Practice Address - Country:US
Practice Address - Phone:831-655-0242
Practice Address - Fax:831-642-0213
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30806103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist