Provider Demographics
NPI:1508908583
Name:GRAZIANO, DEANNA M
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:GRAZIANO
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 1:446 ISLAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4342
Mailing Address - Country:US
Mailing Address - Phone:805-544-7463
Mailing Address - Fax:
Practice Address - Street 1:277 SOUTH ST
Practice Address - Street 2:SUITE Y
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5039
Practice Address - Country:US
Practice Address - Phone:805-541-5144
Practice Address - Fax:805-541-9480
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health