Provider Demographics
NPI:1356654917
Name:GENTILE, BREANNA TARUFELLI (MA)
Entity Type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:TARUFELLI
Last Name:GENTILE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 HARRISON ST APT 724
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-4213
Mailing Address - Country:US
Mailing Address - Phone:509-389-9744
Mailing Address - Fax:
Practice Address - Street 1:5236 CLAREMONT AVE FL 2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1033
Practice Address - Country:US
Practice Address - Phone:510-428-2028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health