Provider Demographics
NPI:1427229228
Name:GIANNULI, MARIA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:M
Last Name:GIANNULI
Suffix:
Gender:F
Credentials:PHD
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 582166
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-0037
Mailing Address - Country:US
Mailing Address - Phone:209-747-2748
Mailing Address - Fax:
Practice Address - Street 1:9825 GOETHE RD
Practice Address - Street 2:CDRC PAROLE POC HEADQUARTERS
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3566
Practice Address - Country:US
Practice Address - Phone:209-747-2748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20474103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical