Provider Demographics
NPI:1376882423
Name:GUGLIELLMINO, DAWN ANNA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:ANNA
Last Name:GUGLIELLMINO
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:PO BOX 3812
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-0812
Mailing Address - Country:US
Mailing Address - Phone:925-330-8518
Mailing Address - Fax:
Practice Address - Street 1:2930 CAMINO DIABLO
Practice Address - Street 2:SUITE 310-D
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3986
Practice Address - Country:US
Practice Address - Phone:925-330-8518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-09
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46655106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist