Provider Demographics
NPI:1326396482
Name:GALLO, MARLENE ANNE
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:ANNE
Last Name:GALLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 ADELINE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-4410
Mailing Address - Country:US
Mailing Address - Phone:510-485-8649
Mailing Address - Fax:
Practice Address - Street 1:2926 ADELINE ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-4410
Practice Address - Country:US
Practice Address - Phone:510-485-8649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist