Provider Demographics
NPI:1275762593
Name:NIERI, MARIA DOMENICA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:DOMENICA
Last Name:NIERI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:DOMENICA
Other - Last Name:TORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 SECOND AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3860
Mailing Address - Country:US
Mailing Address - Phone:650-375-1134
Mailing Address - Fax:
Practice Address - Street 1:126 SECOND AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3860
Practice Address - Country:US
Practice Address - Phone:650-375-1134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist