Provider Demographics
NPI:1437624665
Name:GIROUARD, MARIAH (ASW, PPSC)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:GIROUARD
Suffix:
Gender:F
Credentials:ASW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 14TH ST BLDG H
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-3230
Mailing Address - Country:US
Mailing Address - Phone:510-874-7272
Mailing Address - Fax:
Practice Address - Street 1:991 14TH ST BLDG H
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-3230
Practice Address - Country:US
Practice Address - Phone:510-874-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA96700390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker