Provider Demographics
NPI:1275079964
Name:WAYNES, ARIANA SERENA (LMFT)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:SERENA
Last Name:WAYNES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 MARKET ST STE G
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3456
Mailing Address - Country:US
Mailing Address - Phone:510-770-6263
Mailing Address - Fax:
Practice Address - Street 1:4408 MARKET ST STE G
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-3456
Practice Address - Country:US
Practice Address - Phone:510-770-6263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist